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 reviewers approved by Dr Nicola Ludin
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
This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.Download Article [PDF] View Full Text [HTML][Machine readable]