RESIDUAL INTRARETINAL EDEMA AFTER 25-GAUGE VITRECTOMY AND MACULAR PUCKER REMOVAL: Is Intraoperative Sustained-release Dexamethasone a Real Treatment Option?. Issue 5 (May 2018)

• Record Type: Journal Article
• Authors: Guidi, Gianluca; Casini, Giamberto; Ripandelli, Guido; Piaggi, Paolo; Dalle Lucche, Flavio; Sartini, Mariasole; Loiudice, Pasquale; Nasini, Francesco; Stirpe, Mario; Lazzeri, Stefano
• Is Part Of: Retina. Volume 38:Issue 5(2018)
• Publication Date: 2018-05
• Subjects: ERM removal -- ILM peeling -- intravitreal sustained-release dexamethasone -- Ozurdex implant; Retina -- Diseases -- Periodicals; Retinal Diseases; Vitreous Body; 617.735
• DOI: 10.1097/IAE.0000000000001627
• Languages: English
• ISSNs: 0275-004X

Abstract

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. Abstract : Sixty eyes of 60 pseudophakic patients affected with idiopathic macular pucker were enrolled in this prospective, randomized clinical study to compare functional and anatomical outcomes between eyes that underwent 25-gauge vitrectomy and internal limiting membrane peeling ("Control group") and eyes that received also intraoperative sustained-release dexamethasone ("DEX group").