Adjunctive dexamethasone implant in patients with atopic dermatitis and retinal detachment undergoing vitrectomy and silicone oil tamponade: an interventional case series

Abstract

Background To report the clinical course and outcomes of adjunctive dexamethasone implants in patients with atopic dermatitis (AD) and retinal detachment (RD) undergoing vitrectomy and silicone oil tamponade. Methods This retrospective, interventional case series included AD patients with RD and various degrees of proliferative vitreoretinopathy (PVR) who were scheduled to undergo vitrectomy. Following total vitrectomy and retinopexy, silicone oil tamponade was performed. Finally, an intraocular dexamethasone implant was injected intravitreally. Anatomical and functional outcomes were assessed at 12 months, and extended follow-up data were also collected. Results Seven eyes from six patients (five male, one female) were included. The median age was 29 (range, 20–38) years. Preoperatively, six eyes were pseudophakic, two eyes had a history of previous vitreoretinal surgery, and one had uveitis. Postoperatively, best-corrected visual acuity improved in two eyes, worsened in one, and remained similar in four. Retinal attachment was maintained in all eyes at 12 months. The major complication was an increase in postoperative intraocular pressure in six eyes, requiring either medical or surgical treatment. During the extended follow-up period (15–37 months), retinas remained attached in all eyes and stable visual acuity was maintained in five. Conclusions Injection of an intraoperative dexamethasone implant to silicone oil-filled eyes appears tolerable and may be beneficial in the surgical management of AD patients with RD and PVR.

Effectiveness and Safety of Coadministration of Intravitreal Dexamethasone Implant and Silicone Oil Endotamponade for Proliferative Diabetic Retinopathy with Tractional Diabetic Macular Edema

“…45 Cho and Yoon investigated the effects of coimplantation of silicone oil and IVD during vitrectomy in 7 eyes with atopic dermatitis and retinal detachment in their case series and reported that this could be a tolerable application and beneficial to PVR management. 46 FIG. 2.…”

Current Situation and Challenges in Vitreous Substitutes

“…Several other case reports have shown that the Ozurdex implant (dexamethasone 0.7 mg loaded in a biodegradable sustained‐release intravitreal implant (Allergan Inc., Irvine, CA)) appears to be tolerated by and beneficial to patients with SO tamponade. [ 92–94 ] However, it must be noted that the reported clinical studies are based on a limited number of patients. The drug release from the implant will depend on the phase in which said implant is located, that is to say the aqueous phase or the SO/gas phase, as this release will only be possible in a medium in which the drug can be dissolved.…”

Preoperative, Intraoperative and Postoperative Corticosteroid Use as an Adjunctive Treatment for Rhegmatogenous Retinal Detachment

“…From our systematic review of the literature, we identified 11 studies [40][41][42][43][44][45][46][47][48][49][50] investigating the effects of steroids as an intraoperative adjuvant in RRD surgery. Of the eleven studies, seven had a prospective design but only five were randomized; three studies were retrospective and one study was a case report.…”