Hole-in-one: simple non-surgical technique for the management of anterior chamber migrated Ozurdex ® implant

The migration of a dexamethasone implant to the anterior chamber is a vision-threatening complication which can happen in non-compartmentalized eyes treated with this device. Previous literature suggests that the solution to this complication is almost always surgical and in most cases cannot be delayed. We present the case of a 78-year-old woman with a scleral-fixated IOL and macular edema treated with Ozurdex . She came to us complaining of blurred vision and was subsequently diagnosed with an anterior-chamber migration of her dexamethasone implant. Postural manoeuvres were performed until the dexamethasone implant returned to the vitreous cavity through the pupil. Pilocarpine drops were prescribed with a positive outcome and no further migrations were described. This case shows a practical and efficient way of managing a potentially vision-threatening complication without placing the patient onto an operating table. It is interesting to see how it is possible to relocate a dexamethasone implant despite the presence of a scleral-fixated IOL. Postural manoeuvres are an interesting option in patients with a dexamethasone implant migrated to the anterior chamber. This approach can have very positive outcomes, in addition to avoiding surgery, with all the risks and complications involved.