Efficacy of Combined Vitrectomy with Intravitreal Corticosteroid Injection for Idiopathic Epiretinal Membrane Removal on Anatomical and Functional Outcomes: A Meta-Analysis

Abstract

Background: Macular edema can be a cause of visual loss in eyes undergoing vitrectomy with epiretinal membrane(ERM) peeling. Objective: To evaluate the efficacy of combined vitrectomy with intravitreal corticosteroid injection for ERM. Methods: We conducted a systematic literature review by searching PubMed, Embase, and Medline up to December 2020 for studies that evaluated the effect of intravitreal corticosteroid injection during vitrectomy for ERM. Follow-up data on postoperative best-corrected visual acuity (BCVA) and central macular thickness (CMT) were collected and pooled using the standard mean deviation (SMD) with the corresponding 95% confidence interval (CI). Heterogeneity was statistically quantified using I2 statistics, and a meta-analysis was performed using a random-effects model. Results: Eight studies provided data on a total sample of 443 eyes. The meta-analysis revealed that concomitant intravitreal corticosteroid administration during vitrectomy contributed to a significant reduction in CMT than vitrectomy alone at 3 months after operation (pooled SMD = −0.353; 95% CI, −0.594 to −0.111; p = 0.004). However, between the two groups, no significant difference was found in CMT reduction at 1 and 6 months after operation and in postoperative BCVA improvement at 1, 3, and 6 months after operation. Conclusion: Combined treatment with vitrectomy and intravitreal corticosteroid injection may accelerate CMT reduction 3 months after ERM surgery. However, it did not result in a significant change in CMT and BCVA compared with vitrectomy alone at the end of follow-up.