Ozurdex insert dislocated to the anterior chamber after postration in a patient who underwent secondary implant surgery with Canabrava technique: A case report

• Published in: Acta ophthalmologica (Oxford, England) England), 2024-01, Vol.102 (S279), p.n/a
• Main Authors: Remacha, Carla Sánchez, Simón, Cristina Calvo, Borghi, Luca Bueno, Fernández, Miguel Castillo, Clavería, Julia Aramburu, Martínez, Marta Suñer, Arias, Pablo Cisneros, De Rivas, Marta Orejudo, Moscarda, Eva Josefina Nuñez, Sánchez, Adrián Moñux, Pascual, Paula Casas, Puyuelo, Francisco Javier Ascaso
• Format: Article
• Language: English
• Subjects: Anterior chamber; Case reports; Dexamethasone; Dislocation; Edema; Emergency medical care; Patients; Phenylephrine; Surgery
• ISSN: 1755-375X; 1755-3768
• DOI: 10.1111/aos.15967

Aims/Purpose: To present a case report of a 64‐year‐old man with dislocation of a dexamethasone anterior chamber (AC) implant, who underwent secondary implantation with the Canabrava technique. Methods: A male patient underwent surgery for a secondary implant in the left eye using the Canabrava technique. Post‐operatively, cystic macular oedema was observed on optical coherence tomography (OCT). After 15 days, with no anatomical improvement despite treatment with Nevanac eye drops, a dose of intravitreal injection with Ozurdex® was prescribed. A few days later, the patient came to the emergency department and reported seeing a foreign body in the treated eye. On biomicroscopic examination, an Ozurdex® insert was found in the AC. When the patient was questioned again, he stated that he had been in the praying position the previous days. A new macular OCT was performed, showing resolution of the foveal oedema. Dilation of the LAA with phenylephrine was performed with cephalic manoeuvres in the supine decubitus position, achieving the repositioning of the dexamethasone implant in the vitreous chamber. Finally, an OCT of the anterior pole shows that the secondary implant is normally positioned without complications. Results: After initial treatment with Ozurdex® intravitreal implant, total resolution of the post‐operative cystic macular oedema is achieved, even with dislocation to the anterior chamber. After outpatient management of the dislocation of the implant, we were able to relocate it to the vitreous chamber without the need for surgical management of the patient. Conclusions: In the clinical case, it is demonstrated that the anti‐inflammatory effect of Ozurdex® remains active despite dislocation of the implant to the anterior chamber. Likewise, a good ambulatory technique in the supine position with directed cephalic manoeuvres may be sufficient to reposition the implant without the need for surgery.