Título / Title

INTRAVITREAL DEXAMETHASONE IMPLANT MIGRATION INTO THE ANTERIOR CHAMBER: A MULTICENTER STUDY FROM THE PAN-AMERICAN COLLABORATIVE RETINA STUDY GROUP

Introdução / Purpose

To establish the prevalence of and risk factors for intravitreal dexamethasone implant migration into the anterior chamber in eyes with macular edema and management options to identify the best candidates for implantation and optimal management methods.

Material e Método / Methods

This multicenter, retrospective observational chart review was conducted at the vitreoretinal disease units of 11 Latin American centers. The study included 761 patients with a history of cataract surgery and/or vitrectomy in eyes with macular edema. All patients had retinal diseases that were associated with development of macular edema and had undergone implantation of an intravitreally injected dexamethasone implant. The data collected from the patient charts included age, gender, etiology of the macular edema, history of cataract surgery or vitrectomy, intraocular lens (IOL) status, number of implants injected, and the complications of the implant migration into the anterior chamber.

Resultados / Results

A total of 1,071 intravitreal injections of the dexamethasone implant were administered to 761 patients. The prevalence of migration in these patients, considering the number of injections, was 1.3%. A total of 293 charts had incomplete data and were excluded from the analysis; of the remaining patients, the prevalence of migration, considering the number of injections, was 1.6%. In this subsample, significant associations were seen between implant migration and a history of cataract surgery (P=0.043) and IOL status (P=0.005). The association between implant migration and a history of vitrectomy was marginally significant (P=0.057). The patients with implant migration into the anterior chamber underwent surgical removal of the implant with forceps with or without viscoelastic expression.

Discussão e Conclusões / Conclusion

The risk of implant migration varies from 1.3% to 1.6%. Risk factors for migration were a history of cataract surgery or vitrectomy and aphakia. When anterior migration occurs, rapid removal is advised, especially if corneal edema is present.

Palavras Chave

Dexamethasone Intravitreal Implant, Anterior Chamber Migration, Ozurdex