Anterior migration of Ozurdex implant: a review on risk factors, complications, and management

Abstract

Purpose To describe the common risk factors, complications, and management options for anterior migration of Ozurdex implant. Methods A comprehensive review of the literature was performed. Results Amongst the most common risk factors predisposing to implant anterior migration we found a history of pseudophakia or aphakia or previous vitrectomy. The most common complication is that of corneal edema. Conclusions A variety of management options to treat migration of the dexamethasone implant are utilized by different specialists around the world. These depend on the doctor’s preference, presence of corneal damage and history of previous migrations after repositioning the implant. The most common approaches are operative or non-operative implant repositioning and surgical implant removal.

The Treatment of Diabetic Retinal Edema with Intravitreal Steroids: How and When

“…The CSs have a strong immunosuppressive action, so they can exacerbate all types of infections, and case reports of reactivation of ocular herpetic infection [70] or of acute retinal necrosis [75] after Ozurdex IV implant have been described. d Aphakia, absence or interruption of the posterior capsule, large iridectomy: All these conditions are associated with the risk of the implant migration into the anterior chamber, which has been described both for Ozurdex [172] and for Iluvien [173]. The migration of the implant into the anterior chamber can lead to localized or diffuse corneal edema due to endothelial cell loss, which may be related to the chemical toxicity of the implant components or to the mechanical trauma of the rigid device in contact with the cornea [172,173].…”

“…d Aphakia, absence or interruption of the posterior capsule, large iridectomy: All these conditions are associated with the risk of the implant migration into the anterior chamber, which has been described both for Ozurdex [172] and for Iluvien [173]. The migration of the implant into the anterior chamber can lead to localized or diffuse corneal edema due to endothelial cell loss, which may be related to the chemical toxicity of the implant components or to the mechanical trauma of the rigid device in contact with the cornea [172,173]. e Presence of DME associated with advanced DR or with PDR: Previous studies have shown that both IV anti-VEGF (ranibizumab and aflibercept) [53,54] and IV CSs (TA, Ozurdex, and Iluvien) [46,174,175] used for the treatment of DME were able to simultaneously reduce the risk of DR progression and PDR development.…”