First Author: M.Kotoula GREECE
Co Author(s): E. Papageorgiou F. Xanthou S. Kalampalikis E. Tsironi
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To present migration of dexamethasone implant into the anterior chamber of a pseudophakic eye with rupture of the posterior lens capsule
Ophthalmology Department, University Hospital of Larissa, Greece
: A 65-year-old patient underwent complicated phacoemulsification surgery with rupture of the posterior lens capsule and implantation of a three-piece intraocular lens (IOL) in the sulcus. Deterioration of visual acuity and cystoid macular oedema were noted three weeks after surgery. The patient was diagnosed with Irvine-Gass syndrome and a dexamethasone implant (Ozurdex®) was placed in the vitreal cavity. A week later the patient presented complaining of further vision loss. Slit-lamp examination revealed corneal oedema and dislocation of the implant into the inferior anterior chamber. Under topical anaesthesia the implant was removed and the patient was treated with topical 1% prednisolone eye drops and 5 % hypertonic saline solution.
Corneal oedema was refractory to treatment and resolved after 6 months.
Posterior capsular tear with sulcus-fixated IOL represents a relative contraindication for Ozurdex® implantation. Patients with rupture of the posterior lens capsule with or without history of vitreous prolapse and/or iridectomy are at risk for migration of the implant into the anterior chamber. Prompt diagnosis and treatment are crucial for avoidance of serious complications such as permanent corneal oedema and decompensation.