Efficacy and Safety of Combined Vitrectomy with Intravitreal Dexamethasone Implant for Advanced Stage Epiretinal Membrane
Received 28 August 2019
Accepted for publication 14 November 2019
Published 3 December 2019 Volume 2019:13 Pages 4107—4114
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 3
Editor who approved publication: Dr Georgios D. Panos
Claudio Iovino,1 Giuseppe Giannaccare,2 Marco Pellegrini,2 Federico Bernabei,2 Mirco Braghiroli,1 Tomaso Caporossi,3 Enrico Peiretti1,4
1Department of Surgical Sciences, Eye Clinic, University of Cagliari, Cagliari, Italy; 2Ophthalmology Unit, S. Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy; 3Department of Ophthalmology, Ospedale Careggi, Firenze, Italy; 4Clinica Oculistica, San Giovanni di Dio Hospital, Azienda Ospedaliera Universitaria di Cagliari, Cagliari, Italy
Correspondence: Enrico Peiretti
Eye Clinic, University of Cagliari, Via Ospedale 48, Cagliari 09124, Italy
Purpose: To evaluate the efficacy and safety of combined 25-gauge (G) pars plana vitrectomy (PPV) with intravitreal dexamethasone implant (DXI) for the treatment of advanced stage epiretinal membrane (ERM).
Methods: Forty consecutive pseudophakic eyes with idiopathic stage 3–4 ERM and intraretinal cysts were randomly assigned to two treatment groups. Twenty eyes underwent combined 25-G PPV, ERM peeling and slow-release DXI (DEX group), whereas 20 eyes underwent standard 25-G PPV with ERM peeling only (control group). Differences in postoperative best-corrected visual acuity (BCVA), intraocular pressure (IOP), central macular thickness (CMT) were evaluated.
Results: In all patients, BCVA significantly increased at 1, 3 and 6 months after surgery compared to baseline (all p < 0.05), but at 3 and 6 months, the visual gain was higher in the DEX group (respectively, p = 0.036, p = 0.006). CMT was significantly lower in DEX group compared to control group at 3 and 6 months after surgery (respectively, p = 0.042, p = 0.003). There was no statistically significant difference in IOP change over the course of the follow-up between groups (p > 0.05).
Conclusion: Combined 25-G PPV with DXI is associated with better anatomical and functional outcomes in patients with advanced stage ERM.
Keywords: epiretinal membrane, intravitreal dexamethasone, macular pucker, intraretinal cysts
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