RESIDUAL INTRARETINAL EDEMA AFTER 25-GAUGE VITRECTOMY AND MACULAR PUCKER REMOVAL: Is Intraoperative Sustained-release Dexamethasone a Real Treatment Option?

G. Guidi, G. Casini, G. Ripandelli, P. Piaggi, F. Dalle Lucche, M. Sartini, P. Loiudice, F. Nasini, M. Stirpe, S. Lazzeri

Research output: Contribution to journalArticlepeer-review

Abstract

PURPOSE:: To investigate the efficacy and safety of intraoperative slow-release dexamethasone implant and 25-gauge (G) vitrectomy plus epiretinal membrane removal in patients affected by idiopathic macular pucker. METHODS:: In this randomized, clinical, multicenter study, 60 eyes of 60 pseudophakic eyes having idiopathic macular pucker were enrolled. Thirty eyes underwent 25-G pars plana vitrectomy and internal limiting membrane peeling (“Control group”), whereas 30 eyes underwent 25-G pars plana vitrectomy and internal limiting membrane peeling combined with dexamethasone implant (“DEX group”). Best-corrected visual acuity was investigated using Snellen visual acuity ratio. Anatomical outcomes (foveal thickness and total macular volume) were analyzed with spectral domain optical coherence tomography. RESULTS:: After 6-month follow-up, best-corrected visual acuity significantly increased in each group (P <0.05), but there were no significant differences between groups (P = 0.60). Foveal thickness showed a significant decrease in both groups (P <0.05), but no differences were seen between groups (P = 0.80). Finally, also total macular volume decreased significantly in both groups at the last follow-up visit (P <0.05), but both groups a showed similar trend (P = 0.12). CONCLUSIONS:: Intraoperative sustained-release dexamethasone implant, a powerful antiinflammatory agent with significant efficacy in vitrectomized eyes, did not result in a significant change in macular thickness and volume compared with the vitrectomy alone without dexamethasone implant at 6-month follow-up. These data support the hypothesis that its etiology does not seem to be mainly related to an inflammatory process. © 2017 by Ophthalmic Communications Society, Inc.
Original languageEnglish
Pages (from-to)993-999
JournalRetina
Volume38
Issue number5
DOIs
Publication statusPublished - 2018

Keywords

  • dexamethasone
  • glucocorticoid
  • aged
  • basement membrane
  • clinical trial
  • controlled study
  • delayed release formulation
  • drug implant
  • female
  • human
  • macular edema
  • male
  • middle aged
  • multicenter study
  • pathology
  • procedures
  • randomized controlled trial
  • retina detachment
  • retina macula lutea
  • retrospective study
  • visual acuity
  • vitrectomy
  • Aged
  • Basement Membrane
  • Delayed-Action Preparations
  • Dexamethasone
  • Drug Implants
  • Female
  • Glucocorticoids
  • Humans
  • Macula Lutea
  • Macular Edema
  • Male
  • Middle Aged
  • Retinal Detachment
  • Retrospective Studies
  • Visual Acuity
  • Vitrectomy

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