Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, Baltimore, MD, USA.
Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO, USA.
Eur J Ophthalmol. 2022 Sep;32(5):NP46-NP50. doi: 10.1177/11206721211005696. Epub 2021 Mar 29.
The dexamethasone (DEX) implant is an FDA approved treatment for diabetic macular edema, non-infectious posterior uveitis, and macular edema secondary to branch or central retinal vein occlusions. We describe a case of anterior chamber (AC) migration of a DEX implant in a patient with a history of congenital glaucoma and perform a review of the literature on this particular complication, summarizing the common risk factors, subsequent complications, and management options.
A 46-year-old female with a history of congenital glaucoma, status post cataract extraction with insertion of intraocular lens, pars plana vitrectomy, and Baerveldt tube implant in the left eye was referred for post-operative cystoid macular edema (CME). The patient underwent insertion of a DEX implant, resulting in improvement in her CME. After the fourth implant was injected, the patient noticed a white line in her eye while looking in the mirror after doing jumping jacks. Slit lamp examination confirmed migration of the implant into the AC. Ultimately, the patient was taken to the operating room, where her implant was removed via bimanual vitrectomy through an anterior approach.
This case report and literature review explores the ophthalmic structural changes specific to congenital glaucoma which may have predisposed this eye to anterior migration of the DEX implant. The purpose of this review is to detail the anatomic changes that may increase the risk of anterior chamber implant migration in patients with congenital glaucoma so that physicians may be aware of these risks when selecting patients for this implant.
地塞米松（DEX）植入物是一种获得 FDA 批准的治疗方法，适用于糖尿病性黄斑水肿、非感染性后葡萄膜炎以及分支或中央视网膜静脉阻塞引起的黄斑水肿。我们描述了一例患有先天性青光眼病史的患者前房（AC）中 DEX 植入物迁移的病例，并对该特定并发症的文献进行了回顾，总结了常见的危险因素、后续并发症和治疗选择。
一名 46 岁女性，患有先天性青光眼病史，左眼曾行白内障摘除术并植入人工晶状体、经睫状体平坦部玻璃体切除术和 Baerveldt 管植入术。该患者因术后囊样黄斑水肿（CME）就诊。患者接受了 DEX 植入物的植入，其 CME 得到改善。在第四次植入后，患者在做完跳跃运动后照镜子时注意到眼睛里有一条白线。裂隙灯检查证实植入物已迁移到 AC。最终，患者被送往手术室，通过前入路的双手玻璃体切除术取出了她的植入物。
本病例报告和文献回顾探讨了与先天性青光眼相关的特定眼部结构变化，这些变化可能使该眼更容易发生 DEX 植入物的前迁移。本综述的目的是详细描述可能增加先天性青光眼患者前房植入物迁移风险的解剖结构变化，以便医生在为这些患者选择这种植入物时能够意识到这些风险。
