Treatment of Macular Edema after Pars Plana Vitrectomy for Idiopathic Epiretinal Membrane Using Intravitreal Dexamethasone Implant: Long-Term Outcomes

Chatziralli, Irini; Dimitriou, Eleni; Theodossiadis, George; Chatzirallis, Alexandros; Kazantzis, Dimitrios; Theodossiadis, Panagiotis

doi:10.1159/000496705

Cited by 16 publications

(19 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Based on these concepts, corticosteroids may be able to reduce the inflammatory events related to the mechanical distortion caused by ERM and to the surgical insult. Chatziralli and co-authors investigated the long-term outcomes of DXI for the treatment of macular edema following ERM surgical removal demonstrating its safety and efficacy 12. Likewise, Furino et al demonstrated the efficacy of a single DXI in refractory macular edema secondary to combined cataract extraction and vitrectomy for ERM removal 9…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

<p>Efficacy and Safety of Combined Vitrectomy with Intravitreal Dexamethasone Implant for Advanced Stage Epiretinal Membrane</p>

Iovino

Giannaccare

Pellegrini

et al. 2019

DDDT

View full text Add to dashboard Cite

PurposeTo 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).MethodsForty 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.ResultsIn 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).ConclusionCombined 25-G PPV with DXI is associated with better anatomical and functional outcomes in patients with advanced stage ERM.

show abstract

Section: Discussionmentioning

confidence: 99%

“…A power analysis indicated that a minimum sample of 24 patients was required to detect a 0.017 logMAR difference in terms of BCVA between groups, with a power of 80% and a significance level of 0.05 12…”

Section: Methodsmentioning

confidence: 99%

<p>Efficacy and Safety of Combined Vitrectomy with Intravitreal Dexamethasone Implant for Advanced Stage Epiretinal Membrane</p>

Iovino

Giannaccare

Pellegrini

et al. 2019

DDDT

View full text Add to dashboard Cite

show abstract

“…Increasing the supply of oxygen to the retina and henceforth improving retinal ischemia. The viscosity of vitreous is 300-2,000 times greater than aqueous viscosity, the diffusion constant of molecules in the vitreous ought to multiply by an analogous magnitude after vitrectomy 11 .…”

Section: Resultsmentioning

confidence: 98%

Visual And Anatomical Outcomes of Pars Plana Vitrectomy in Refractory Diabetic Macular Edema

Khaqan¹,

Imtiaz²,

Bukhsh³

et al. 2020

pak J Ophthalmol

View full text Add to dashboard Cite

Purpose: To find the visual and anatomical outcomes of pars plana vitrectomy in cases of refractory diabetic macular edema. Study Design: Quasi Experimental study. Place and Duration of Study: Department of Ophthalmology, Lahore General Hospital from January 2013 to April 2019. Material and Methods: Seventy-six patients between the age of 18 and 60 years of both genders having refractory diabetic macular edema with macular thickness of 400 micrometers or more on OCT were enrolled. Informed consent was taken. Detailed preoperative workup including visual assessment, examination on slit lamp using 90D or 78D lens for assessment of macular edema and OCT was done. Patients underwent pars plana vitrectomy, ERM, and ILM peeling. Visual assessment and macular thickness was recorded 4 weeks after surgery. Results: This study included 76 patients with the mean age of 48.15 ± 8.16 years. Patients were further categorized according to age into 2 groups. The gender distribution of patients showed that most of the participants were female in this study. Mean duration of Diabetes Mellitus was 9.95 ± 6.29 years. Most of the patients did not have previous history of laser and only three patients (3.9%) did not receive Intravitreal Anti-VEGF. Mean preoperative visual acuity was 0.44 ± 0.13 while postoperative visual acuity was 0.876 ± 0.18 (P = 0.000). Similarly, significant decrease in macular thickness was observed after the procedure (P = 0.000). Conclusion: Pars plana vitrectomy, ERM and ILM peeling can be an effective treatment option for refractory diabetic macular edema.

show abstract

“…In particular, several authors reported the use of intravitreal dexamethasone implant (DEX) for macular oedema secondary to vitrectomy for epiretinal membrane (ERM) and rhegmatogenous retinal detachment (RRD), showing promising results [6][7][8][9][10][11][12][13]. However, most of these studies were limited by a small sample size and retrospective design.…”

Section: Introductionmentioning

confidence: 99%

Intravitreal Dexamethasone Implant for Postoperative Macular Oedema Secondary to Vitrectomy for Epiretinal Membrane and Retinal Detachment: A Systematic Review and Meta-Analysis

Parisi

Fallico

Avitabile

et al. 2021

Journal of Ophthalmology

View full text Add to dashboard Cite

Purpose. To evaluate the efficacy of intravitreal dexamethasone implant (DEX) for the treatment of macular oedema secondary to vitrectomy for epiretinal membrane (ERM) and retinal detachment (RD) by conducting a systematic review with meta-analysis of published studies. Methods. Studies reporting clinical outcomes of DEX use for the treatment of macular oedema secondary to ERM and RD vitrectomy were searched on PubMed and Embase databases. The primary outcome was best-corrected visual acuity (BCVA) change between baseline and post-DEX treatment, reported as mean difference (MD) with 95% confidence interval (CI). Mean central macular thickness (CMT) change was assessed as a secondary outcome. Postimplant adverse events, including intraocular pressure rise and cataract development, were reported as well. Results. Five uncontrolled studies, 1 nonrandomized controlled study, and 1 randomized controlled study were included, with a total of 5 cohorts and 3 cohorts in the ERM group and RD group, respectively. Considering the last available follow-up, a significant improvement in postimplant BCVA was found in the overall population, irrespective of the indication for vitrectomy (MD = −0.28, 95% CI = −0.37, −0.20; p < 0.001 ), but with significant heterogeneity. In either group, mean BCVA significantly improved following the implant (in the ERM group, MD = −0.31, 95% CI = −0.40, −0.22; in the RD group, MD = −0.22, 95% CI = −0.41, −0.03), with no difference between the two groups ( p = 0.41 ). However, there was significant heterogeneity in both groups. Considering the last available follow-up, a significant CMT reduction was found in the overall population, irrespective of the indication for vitrectomy (MD = −129.75, 95% CI = −157.49, −102.01; p < 0.001 ). In the ERM group, a significant CMT reduction was shown following DEX (MD = −133.41, 95% CI = −155.37, −111.45; p < 0.001 ), with no heterogeneity. In the RD group, mean CMT reduction was borderline significant (MD = −128.37, 95% CI = −253.57, −3.18; p = 0.040 ), with significant heterogeneity. No difference in CMT improvement was found between the two groups ( p = 0.94 ). Conclusion. This meta-analysis showed that DEX yielded a significant improvement in visual and anatomical outcomes, even if limited by significant heterogeneity. Dexamethasone implant represents an effective treatment for postoperative macular oedema secondary to ERM and RD vitrectomy.

show abstract

Treatment of Macular Edema after Pars Plana Vitrectomy for Idiopathic Epiretinal Membrane Using Intravitreal Dexamethasone Implant: Long-Term Outcomes

Cited by 16 publications

References 25 publications

<p>Efficacy and Safety of Combined Vitrectomy with Intravitreal Dexamethasone Implant for Advanced Stage Epiretinal Membrane</p>

<p>Efficacy and Safety of Combined Vitrectomy with Intravitreal Dexamethasone Implant for Advanced Stage Epiretinal Membrane</p>

Visual And Anatomical Outcomes of Pars Plana Vitrectomy in Refractory Diabetic Macular Edema

Intravitreal Dexamethasone Implant for Postoperative Macular Oedema Secondary to Vitrectomy for Epiretinal Membrane and Retinal Detachment: A Systematic Review and Meta-Analysis

Contact Info

Product

Resources

About