Unit of Ophthalmology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy.
Catholic University of "Sacro Cuore", Rome, Italy.
Graefes Arch Clin Exp Ophthalmol. 2021 Feb;259(2):379-385. doi: 10.1007/s00417-020-04911-5. Epub 2020 Sep 6.
To evaluate the efficacy of intraoperative slow-release dexamethasone implant (DEX) combined with removal of idiopathic epiretinal membrane (ERM).
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.
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.
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.
评估术中缓释地塞米松植入物(DEX)联合特发性视网膜前膜(ERM)切除的疗效。
在这项观察性回顾性研究中,分析了 40 名患有特发性 ERM 的有晶状体眼患者的数据。所有患者均接受白内障超声乳化术、25G (G)经睫状体平坦部玻璃体切除术(PPV)、ERM 切除联合 DEX 植入物(“DEX YES”组,#20)或不联合 DEX 植入物(“DEX NO”组,#20)。我们收集了最佳矫正视力(BCVA)<20/40 视力表、中央黄斑厚度(CMT)≤400μm(SD-OCT 测量)和黄斑下椭圆体/类椭圆体带完整性的相关数据。在基线以及术后 15、30 和 90 天时评估 BCVA、CMT 和眼内压(IOP)。
在“DEX YES”组中,15、30 和 90 天时 BCVA 有显著改善(p<0.001),而在“DEX NO”组中,仅在 30 和 90 天时观察到改善(p<0.001)。在两组中,CMT 在每次随访时均显著降低(p<0.001),且每次随访时 IOP 均无明显升高。
在这项研究中,DEX 在术后 15 天加速了 BCVA 的改善。然而,在 25-G PPV 切除特发性 ERM 后 30 和 90 天的随访中,没有观察到 DEX 在解剖学(CMT)和功能(BCVA)方面的进一步有效性的证据。