Evaluation of intraoperative slow-release dexamethasone implant combined with idiopathic epiretinal membrane removal

Graefes Arch Clin Exp Ophthalmol. 2021 Feb;259(2):379-385. doi: 10.1007/s00417-020-04911-5. Epub 2020 Sep 6.

Abstract

Purpose: To evaluate the efficacy of intraoperative slow-release dexamethasone implant (DEX) combined with removal of idiopathic epiretinal membrane (ERM).

Methods: In this observational retrospective study, data of 40 patients with phakic eyes affected by idiopathic ERM were analysed. All patients underwent cataract phacoemulsification, 25-gauge (G) pars plana vitrectomy (PPV), ERM removal with DEX implant ("DEX YES" group, #20) or without DEX implant ("DEX NO" group, #20). We collected data on best-corrected visual acuity (BCVA) < 20/40 Snellen charts, central macular thickness (CMT) ≤ 400 μm (measured by SD-OCT) and integrity of sub-foveal ellipsoid/myoid zone. BCVA, CMT and intraocular pressure (IOP) were evaluated at baseline as well as 15, 30 and 90 days after surgery.

Results: In the "DEX YES" group, statistically significant BCVA improvement was observed at 15, 30 and 90 days (p < 0.001), while in the "DEX NO" group, improvements were observed only at 30 and 90 days (p < 0.001). In both groups, CMT significantly decreased at each follow-up visit (p < 0.001), and no statistically significant increase of IOP was detected at each follow-up visit.

Conclusions: In this study, DEX accelerated the improvement of BCVA at 15 days after surgery. However, no evidence of further anatomical (CMT) and functional (BCVA) DEX effectiveness combined with removal of idiopathic ERM by 25-G PPV at 30 and 90 days follow-up was observed.

Keywords: Epiretinal membrane; Innovative biotechnology; Intravitreal dexamethasone; Macular pucker; Personalized medicine; Vitrectomy.

Publication types

  • Observational Study

MeSH terms

  • Dexamethasone
  • Drug Implants
  • Epiretinal Membrane* / diagnosis
  • Epiretinal Membrane* / surgery
  • Glucocorticoids
  • Humans
  • Retrospective Studies
  • Visual Acuity
  • Vitrectomy

Substances

  • Drug Implants
  • Glucocorticoids
  • Dexamethasone