The clinical efficiency and complication analysis of dexamethasone sustained release intraocular implantation in macular edema after vitrectomy
10.3760/cma.j.cn431274-20211206-01269
- VernacularTitle:地塞米松缓释剂眼内植入治疗玻璃体切除术后继发黄斑水肿的临床分析
- Author:
Yongpeng ZHANG
1
;
Liyun JIA
;
Liqin GAO
;
Xusheng CAO
;
Cong WANG
;
Kai MA
Author Information
1. 首都医科大学附属北京同仁医院，北京同仁眼科中心，北京市眼科学与视觉科学重点实验室，北京 100730
- Keywords:
Vitrectomy;
Macular edema;
Dexamethasone;
Delayed-action preparations;
Intravitreal injections
- From:
Journal of Chinese Physician
2022;24(1):13-18
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the efficiency, safety and complication of 0.7 mg dexamethasone sustained release agent (Ozurdex ?) vitreous cavity implantation for macular edema secondary to vitrectomy. Methods:A total of 15 patients (16 eyes) were included in this retrospective case series study. There were 7 males (8 eyes) and 8 females (8 eyes). Age ranged from 47 to 72 years old with an average age of (60.2±8.6)years. Among them, 8 cases were diabetic retinopathy (6 cases combined cataract surgery). 4 cases were silicone oil removal after retinal detachment surgery (all combined cataract surgery). 2 cases were epi-macular membrane (all combined with cataract surgery) and 1 case was vitreous hemorrhage (combined with cataract surgery). Ozurdex ? was implanted for macular edema after vitrectomy. The number of implantation was from 1 to 3 times (mean 1.67 times). The follow-up time was from 3 to 12 months, with an average of (7.33±3.50)months. Results:The best corrected visual acuity (BCVA) was improved in 10 cases (11 eyes), unchanged in 4 cases and decreased in 1 case within 3 months after Ozurdex ? implantation in the 15 cases (16 eyes). The macular edema was significantly improved in all cases. The central macular thickness (CMT) measured by optical coherence tomography (OCT) was from 350 to 1 370 γm before surgery with average thickness (621.60±235.48)γm, and the CMT postoperative was 118 to 556 γm with average thickness (269.87±118.14)γm, with statistically significant difference ( P<0.001). Cataract was not progressive after Ozurdex ? implantation. Macular edema was recurrent in 7 cases after first implantation and stable for additional 1-2 injections. Intraocular pressure elevation occurred in 3 cases 1 to 2 months after implantation with the highest intraocular pressure of 36 mmHg, which were controlled by local anti-glaucoma eye drops. Drugs entered into the anterior chamber in 2 cases and was taken out in 1 case. Conclusions:The efficiency of Ozurdex ? vitreous cavity implantation is definite and the complications are controllable, so it is a safe and effective method to treat macular edema after vitrectomy.
