Foreign body reaction with delayed extrusion of ganciclovir implant in a patient with immune recovery vitritis syndrome

Abstract

PURPOSE: To report a case of delayed extrusion of primary ganciclovir implants in a patient with immune recovery vitritis syndrome. METHOD: Interventional case report. A 54-year-old HIV positive male patient with immune recovery vitritis syndrome had spontaneous extrusion of bilateral ganciclovir devices 4 years after primary implantation. RESULT: The extruded ganciclovir implants were removed from both eyes, and removal was complicated by vitreous hemorrhage in one eye. Histopathological examination of the extruded implant, LE, showed marked inflammation and evidence of foreign body reaction. CONCLUSION: Excess inflammation in eyes with immune recovery vitritis syndrome may trigger a foreign body reaction that results in a delayed extrusion of primary ganciclovir implants. The site of ganciclovir implants in patients with immune recovery vitritis syndrome should be regularly inspected for eroding struts to prevent secondary endophthalmitis.