Kwon Jin-Woo, Park Young-Gun
Department of Ophthalmology, St. Vincent's Hospital, College of Medicine, the Catholic University of Korea, Seoul, Korea; and.
Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Korea.
Retina. 2022 Apr 1;42(4):782-788. doi: 10.1097/IAE.0000000000003380.
To identify the clinical outcomes of intravitreal dexamethasone implantation (IVD) in previously vitrectomized eyes of patients with diabetic macular edema.
We performed a retrospective observational study. We recorded central subfield thickness, best-corrected visual acuity, and intraocular pressure up to 12 months after IVD implant placement. We compared the duration of IVD action, intraocular pressure trends, and the prevalence of ocular hypertension after the first IVD treatment of nonvitrectomized and vitrectomized eyes. We also compared the central subfield thickness, best-corrected visual acuity, number of IVD treatments, and prevalence of ocular hypertension between the 2 groups after 12 months.
We found no significant between-group differences in the central subfield thickness, best-corrected visual acuity, or the prevalence of ocular hypertension during treatment. However, the duration of action of the first IVD treatment was significantly shorter in vitrectomized eyes, and these eyes required more IVD treatments during the 12-month follow-up period. The maximal average intraocular pressure was observed at 2 months after the first IVD treatment in the nonvitrectomized group, but 1 month after the first IVD treatment in the vitrectomized group.
These findings suggest that the IVD pharmacokinetics and pharmacodynamics differ between vitrectomized and nonvitrectomized eyes. Nevertheless, given the relatively long-lasting effectiveness of the treatment and the good clinical results, consecutive IVD treatments may be beneficial for patients with diabetic macular edema with previously vitrectomized eyes.
确定玻璃体内注射地塞米松植入术（IVD）在糖尿病性黄斑水肿患者既往已行玻璃体切割术的眼中的临床疗效。
我们进行了一项回顾性观察研究。记录了IVD植入后长达12个月的中心子野厚度、最佳矫正视力和眼压。我们比较了非玻璃体切割眼和玻璃体切割眼首次IVD治疗后的IVD作用持续时间、眼压趋势以及高眼压的发生率。我们还比较了两组在12个月后的中心子野厚度、最佳矫正视力、IVD治疗次数以及高眼压的发生率。
我们发现治疗期间两组在中心子野厚度、最佳矫正视力或高眼压发生率方面无显著差异。然而，玻璃体切割眼首次IVD治疗的作用持续时间明显较短，并且在12个月的随访期内这些眼睛需要更多的IVD治疗。非玻璃体切割组在首次IVD治疗后2个月观察到最大平均眼压，而玻璃体切割组在首次IVD治疗后1个月观察到。
这些发现表明玻璃体切割眼和非玻璃体切割眼的IVD药代动力学和药效动力学不同。尽管如此，鉴于该治疗具有相对持久的有效性和良好的临床效果，连续进行IVD治疗可能对既往已行玻璃体切割术的糖尿病性黄斑水肿患者有益。
