Research progress on the migration of intravitreal dexamethasone implant into anterior chamber

Dexamethasone intravitreal implant(Ozurdex)is approved for the treatment of macular edema secondary to retinal vein occlusion, diabetic retinopathy, and non-infectious uveitis. It has also been reported to treat macular edema after intraocular surgery and macular edema secondary to other inflammation-related ocular fundus diseases. With the widespread application of dexamethasone intravitreal implant, uncommon complications such as migration of dexamethasone intravitreal implant into the anterior chamber are gradually receiving attention. Anterior chamber migration of dexamethasone intravitreal implant usually occurs in the eyes with an incomplete complex of suspensory ligament and lens capsule or after vitrectomy. After dexamethasone intravitreal implant migrates into the anterior chamber, it tends to sink to a lower angle, resembling hypopyon, causing vision impairment and eye pain, accompanied by corneal edema and intraocular hypertension. If corneal edema occurs, dexamethasone intravitreal implant should be repositioned or removed as soon as possible to reduce the risk of corneal endothelial decompensation. Miosis and avoiding predispositions, such as lying prone, jumping, or long flights, can prevent dexamethasone intravitreal implant from migrating into the anterior chamber. In this paper, the recent advances in anterior chamber migration of dexamethasone intravitreal implant are reviewed to provide a reference for the diagnosis, treatment, and prevention.