Anterior migration of intravitreal fluocinolone acetonide (Iluvien®) implant in a pseudophakic eye with intact posterior capsule.

PURPOSE

To describe a case of spontaneous anterior migration of intravitreal fluocinolone acetonide (Iluvien®) implant in a pseudophakic eye with intact posterior capsule.

OBSERVATION

A 60-year old woman with proliferative diabetic retinopathy underwent uneventful pars plana vitrectomy and phacoemulsification with posterior chamber intraocular lens (PCIOL) implants in both eyes. She developed diabetic macular edema (DME) in her right eye which failed to respond to repeated intravitreal injections of Aflibercept 2mg/0.05ml (Eylea®). The patient received an intravitreal Iluvien® implant to treat the recalcitrant DME after she showed a favorable temporary response to dexamethasone intravitreal implant (Ozurdex™).Six months later she presented with pain in the right eye due to elevated intraocular pressure (IOP). The Iluvien® implant was found to be dislodged into the anterior chamber (AC) in the presence of an intact posterior capsule and stable PCIOL implant. The migrated Iluvien implant was removed and IOP was controlled with a glaucoma drainage valve as it failed to respond to maximum anti-glaucoma medication.

CONCLUSIONS AND IMPORTANCE

Intravitreal Iluvien® implant could migrate into the AC in a previously vitrectomized eyes in the presence of an intact posterior capsule.