Ozturk Yucel, Calli Umit, Gungor Bengi, Kumral Esra Turkseven, Balci Sevcan Yildiz, Kugu Suleyman, Yenerel Nursal Melda
Department of Ophthalmology, University of Health Sciences Haydarpasa Numune Training and Research Hospital, Istanbul, Türkiye.
Department of Ophthalmology, University Health Sciences, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Türkiye.
Beyoglu Eye J. 2023 May 1;8(2):81-90. doi: 10.14744/bej.2023.00922. eCollection 2023.
The objective of the study is to evaluate anatomical and functional results such as best corrected visual acuity (BCVA), central macular thickness (CMT), and intraocular pressure (IOP) in patients who received intravitreal dexamethasone (DEX) implant for diabetic macular edema (DME), and to compare the efficacy according to patients' lens status and concurrent phacoemulsification surgery.
A total of 70 eyes of 55 patients with DME who received intravitreal DEX implantation were included in this retrospective study. Patients who received intravitreal DEX implantation were divided into three groups phaco-DEX (group 1), pseudophakic (group 2), and phakic (group 3). The BCVA, CMT, and IOP changes were compared between the three groups.
One month after the intravitreal DEX implant, BCVA improved in all three groups. (p=0.001, p=0.01, and p=0.009, respectively). There was a decrease in CMT at the end of 1 and 4 months in all three groups compared to the preoperative measurements (p=0.005, p<0.001, p<0.001 respectively). While IOP was increased in group 2 and group 3, no IOP increase was observed in group 1. (p=0.41, p=0.01, and p=0.01, respectively).
Combining intravitreal DEX implantation with phacoemulsification surgery seems to be an effective and reliable method in patients with DME accompanied by cataract. The IOP elevation in follow-up visits of phakic and pseudophakic patients after intravitreal DEX implantation was not observed in the Phaco-DEX group.
本研究的目的是评估接受玻璃体内地塞米松（DEX）植入治疗糖尿病性黄斑水肿（DME）患者的解剖学和功能结果，如最佳矫正视力（BCVA）、中心黄斑厚度（CMT）和眼压（IOP），并根据患者的晶状体状态和同期白内障超声乳化手术比较疗效。
本回顾性研究纳入了55例接受玻璃体内DEX植入的DME患者的70只眼。接受玻璃体内DEX植入的患者分为三组：超声乳化-DEX组（第1组）、人工晶状体眼组（第2组）和晶状体眼组（第3组）。比较三组之间的BCVA、CMT和IOP变化。
玻璃体内DEX植入后1个月，三组的BCVA均有所改善。（分别为p = 0.001、p = 0.01和p = 0.009）。与术前测量相比，所有三组在1个月和4个月末CMT均降低。（分别为p = 0.005、p < 0.001、p < 0.001）。虽然第2组和第3组的IOP升高，但第1组未观察到IOP升高。（分别为p = 0.41、p = 0.01和p = 0.01）。
玻璃体内DEX植入联合白内障超声乳化手术似乎是治疗伴有白内障的DME患者的一种有效且可靠的方法。在超声乳化-DEX组中，未观察到晶状体眼和人工晶状体眼患者在玻璃体内DEX植入术后随访期间的IOP升高。
