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Ophthalmic Images
September 12, 2019

Anterior Chamber Migration of Fluocinolone Acetonide Intravitreal Implant

Author Affiliations
  • 1Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India
  • 2Department of Uvea, Sankara Nethralaya, Chennai, Tamil Nadu, India
JAMA Ophthalmol. 2019;137(9):e185931. doi:10.1001/jamaophthalmol.2018.5931

A 41-year-old man reported visual obscuration in his left eye of 2 weeks’ duration after a history of a fluocinolone acetonide intravitreal implant 5 years ago for intermediate uveitis. Examination revealed fluocinolone acetonide intravitreal implant in the anterior chamber with pseudophakodonesis (Figure). Examination revealed chronic cystoid changes at the macula. Drug pellet dissociation from the implant strut is not uncommon.1,2 Drug pellet migration in the anterior chamber has been reported before in eyes with known risk factors.3,4 Almeida et al5 reported on the anterior chamber migration of the whole implant and removal through the limbal route. Their case had complicated cataract surgery with open capsule, large iridectomy, and 3 sequential fluocinolone acetonide implant surgeries. In this case, the implant was surgically removed through the pars plana route, and intraocular lens was sutured to the sclera under partial-thickness scleral flap with 10-0 polypropylene suture. Visual acuity remained stable at 6/36 six weeks after the surgical procedure.