YAG Laser-Assisted Fragmentation of Dexamethasone Implants in the Anterior Chamber.

Abstract

To report efficacy on the use of neodymium yag laser in fragmentating dexamethasone intravitreal implant (Ozurdex, Allergan, Inc, Irvine, CA) migrated in the anterior chamber (AC). Multicenter, retrospective, interventional case series of 10 patients treated with Nd:Yag laser following spontaneous migration of dexamethasone implant into the AC. The Nd:yag laser successfully fragmented the migrated implants in all cases without severe complications. No patient exhibited corneal edema at 4 months post-treatment. Visual acuity remained stable or improved in four patients, while one patient had minimal transient visual deterioration due to pre-existing retinal conditions. In all patients resolution of previous macular edema was detected. Spontaneous migration of the dexamethasone intravitreal implant into the anterior chamber can occur in patients with aphakia, prior pars plana vitrectomy, or compromised capsular support. Timely intervention using Nd:yag laser can effectively fragment the dexamethasone implant, mitigating the risk of corneal endothelial damage and preserving visual function. In this cohort Nd:yag laser appeared a safe and effective treatment option for managing anterior chamber migration of the dexamethasone intravitreal implant, avoiding the need for more invasive surgical techniques or temporary non-invasive techniques.