Doganay Selim, Ucan Gunduz Gamze, Kiristioglu Mehmet Omer, Demirel Elif, Yalcinbayir Ozgur
Department of Ophthalmology, Bursa Uludag University School of Medicine, Bursa, Turkey.
Eye (Lond). 2025 Feb;39(3):586-592. doi: 10.1038/s41433-024-03570-8. Epub 2025 Jan 7.
To evaluate the efficacy and safety of dexamethasone implantation in the supraciliary (SC) space, a novel and potential effective implantation site, compared to intravitreal (IV) application.
This prospective study included 39 eyes of 38 patients with macular oedema (ME) who underwent SC and IV dexamethasone implantation (SC-DEX and IV-DEX). Patients were randomly assigned to treatment groups and followed for 3 months. Preoperative and postoperative assessments included maximum retinal thickness (MRT), change in central retinal thickness between consecutive visits (ΔCRT), intraocular pressure (IOP), and best corrected visual acuity (BCVA).
Both SC-DEX and IV-DEX groups showed significant MRT reductions during at follow-up. In the SC group, MRT significantly decreased at 1st and 3rd months (p = 0.0002 for both), but not at 1st week (p = 0.2517). In the IV-DEX group, significant reductions in MRT were observed at all postoperative visits: 1st week (p = 0.0002), 1st month (p = 0.0004), and 3rd month (p = 0.0003). There were no significant differences in the change in ΔCRT between the SC-DEX and IV-DEX groups at any visit (p > 0.05). IOP did not show significant changes (p > 0.05). BCVA improved significantly in the SC group compared to the IV-DEX group during the first week (p = 0.014). No other perioperative or postoperative sight-threatening complications were noted in either group, including hypotony or endophthalmitis.
SC-DEX shows promise as an alternative for managing ME, offering similar effectiveness to IV-DEX with safe profile. Further studies are needed to confirm its long-term safety and efficacy.
与玻璃体内（IV）应用相比，评估地塞米松植入睫状体上腔（SC）这一新型且可能有效的植入部位的疗效和安全性。
这项前瞻性研究纳入了38例黄斑水肿（ME）患者的39只眼，这些患者接受了睫状体上腔和玻璃体内地塞米松植入（SC-DEX和IV-DEX）。患者被随机分配至治疗组，并随访3个月。术前和术后评估包括最大视网膜厚度（MRT）、连续随访间中心视网膜厚度的变化（ΔCRT）、眼压（IOP）和最佳矫正视力（BCVA）。
SC-DEX组和IV-DEX组在随访期间MRT均显著降低。在SC组，MRT在第1个月和第3个月时显著降低（两者p均 = 0.0002），但在第1周时未降低（p = 0.2517）。在IV-DEX组，术后各次随访时MRT均显著降低：第1周（p = 0.0002）、第1个月（p = 0.0004）和第3个月（p = 0.0003）。SC-DEX组和IV-DEX组在任何一次随访时ΔCRT的变化均无显著差异（p > 0.05）。眼压未显示出显著变化（p > 0.）。与IV-DEX组相比，SC组在第1周时BCVA显著改善（p = 0.014）。两组均未观察到其他围手术期或术后威胁视力的并发症，包括低眼压或眼内炎。
SC-DEX有望成为治疗ME的一种替代方法，其有效性与IV-DEX相似且安全性良好。需要进一步研究来证实其长期安全性和疗效。
