Corneal graft failure due to migration of Ozurdex™ implant into the anterior chamber

Abstract

Purpose: We report a case of corneal endothelial graft failure secondary to dexamethasone intravitreal implant (Ozurdex™) migration into the anterior chamber (AC). Observations: A 53-year-old man with a history of bilateral idiopathic chronic uveitis, had a right anterior vitrectomy and AC intraocular lens (ACIOL) with a peripheral iridotomy. He received an intravitreal Ozurdex™ implant for right cystoid macular oedema (CMO). Three months later he developed pseudophakic bullous keratopathy and underwent a Descemet stripping automated endothelial keratoplasty (DSAEK), combined with IOL exchange (ACIOL explantation followed by scleral fixated posterior chamber IOL). He developed recurrent CMO post-operatively, for which he had a second Ozurdex™ implant. Six weeks following the implant he presented with reduced vision and corneal graft failure with migration of the Ozurdex™ implant into the AC. Despite prompt surgical removal of the implant, the graft did not recover and he underwent a repeat DSAEK. Conclusions and importance: Ophthalmologists should be aware of this adverse event and the importance of early implant removal to reduce the risk of permanent corneal oedema.

Keywords

• Corneal graft failure
• Cystoid macular oedema
• Ozurdex implant migration
• Uveitis