Association of intravitreal and topical anti‐inflammatory therapies on short‐term anatomical and functional outcomes following epiretinal membrane surgery

Abstract

PurposeHere we examine the association of anti‐inflammatory therapy with anatomical and functional outcomes of epiretinal membrane surgery.MethodsThe study included consecutive patients having gone through epiretinal membrane surgery at Helsinki University Hospital, Finland, between 2017 and 2021. The association of perioperative intravitreal and postoperative topical anti‐inflammatory therapies with surgical outcomes was assessed.ResultsIn total, 214 eyes of 214 patients with a mean age of 71.2 ± 8.2 years were studied. At 1‐month, perioperative intravitreal use of triamcinolone acetonide (n = 27) was associated with a significant proportional and absolute improvement in foveal thickness (−15.9 ± 18.4% vs. −4.2 ± 25.6%, p = 0.003 and −86.2 ± 109.6 μm vs. −33.7 ± 94.3 μm, p = 0.004), and central subfield macular thickness (−14.7 ± 16.5% vs. −6.3 ± 16.9%, p = 0.009 and −80.6 ± 102.8 μm vs. −36.1 ± 75.9 μm, p = 0.004) when compared to those without triamcinolone acetonide. Furthermore, best‐corrected visual acuity (BCVA) gain showed a non‐significant yet corresponding trend favouring intraoperative intravitreal use of triamcinolone acetonide (0.21 ± 0.27 vs. 0.09 ± 0.28 LogMAR units, p = 0.062). Postoperative use of topical non‐steroidal anti‐inflammatory drugs (NSAIDs) (n = 36) as adjunct therapy showed no significant advantage in anatomical outcomes or BCVA gain when compared to those without NSAIDs (all p > 0.05). Triamcinolone acetonide remained significant for proportional and absolute improvement in foveal thickness (p = 0.019 and p = 0.006) and in central subfield macular thickness (p = 0.013 and p = 0.006) when controlled for confounding factors patient age and gender and topical NSAID use.ConclusionsIntraoperative intravitreal use of triamcinolone acetonide improved short‐term anatomical outcomes in patients who underwent epiretinal membrane surgery.