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Ophthalmic Images
October 8, 2020

Migration of a Fluocinolone Acetonide Intravitreal Implant Into the Anterior Chamber

Author Affiliations
  • 1Stanford University School of Medicine, Stanford University, Palo Alto, California
  • 2Department of Ophthalmology, Byers Eye Institute, Stanford University, Palo Alto, California
JAMA Ophthalmol. 2020;138(10):e201388. doi:10.1001/jamaophthalmol.2020.1388

Two days after receiving an 0.18-mg intravitreal fluocinolone acetonide implant (Yutiq; EyePoint Pharmaceuticals) in his left eye, a 30-year-old man returned to the clinic. He denied pain or visual changes. On examination, the implant was visible in the anterior chamber (Figure), with no corneal edema, hyphema, or intraocular pressure elevation. The patient had a history of a ruptured globe with a resulting iris defect, retinal detachment after a vitrectomy, a posterior capsular tear, anterior chamber inflammation, and chronic cystoid macular edema. His baseline visual acuity (20/70 OS) improved to 20/40 OS with intravitreal steroid injections but worsened to 20/70 OS when the cystoid macular edema recurred after injections were ceased. Because the patient had declined surgery or recurrent injections, he had consented to and received the implant after a careful discussion of risks, including migration into the anterior chamber,1 as indicated in the product description for those without intact posterior capsules. Immediately after surgery to remove the implant, his cornea was clear and his visual acuity was 20/70 OS.

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