Minimally Invasive Microincision Vitrectomy Surgery with an Intraoperative Dexamethasone Implant for Refractory Diabetic Macular Edema

Ophthalmologica. 2016;235(3):150-6. doi: 10.1159/000443751. Epub 2016 Feb 24.

Abstract

Purpose: To evaluate the 1-year results of 25-gauge microincision vitrectomy surgery (MIVS25) combined with intraoperative dexamethasone (DEX) implant for persistent diabetic macular edema (DME).

Methods: This study enrolled patients who had a history of DME for ≥12 months and underwent MIVS25 and DEX implant injection. Best corrected visual acuity (BCVA) and central retinal thickness (CRT) were assessed postoperatively.

Results: Eighteen eyes were included in the analysis. Preoperatively, logMAR BCVA was 0.90 and CRT was 594 µm on average. CRT decreased until the 3-month follow-up visit and tended to increase at 6 months, but stabilized at 12 months with additional treatments in five eyes at 5 months postoperatively. Statistically significant improvement in BCVA was noted 1 month after treatment and at each subsequent follow-up visit (p < 0.001).

Conclusion: MIVS25 combined with DEX implant injection might be utilized as an effective and safe alternative treatment for intractable DME.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Combined Modality Therapy
  • Dexamethasone / administration & dosage*
  • Diabetic Retinopathy / drug therapy
  • Diabetic Retinopathy / physiopathology
  • Diabetic Retinopathy / surgery
  • Diabetic Retinopathy / therapy*
  • Drug Implants
  • Female
  • Glucocorticoids / administration & dosage*
  • Humans
  • Intraoperative Period
  • Intravitreal Injections
  • Macular Edema / drug therapy
  • Macular Edema / physiopathology
  • Macular Edema / surgery
  • Macular Edema / therapy*
  • Male
  • Microsurgery / methods
  • Middle Aged
  • Minimally Invasive Surgical Procedures
  • Retrospective Studies
  • Tomography, Optical Coherence
  • Visual Acuity / physiology
  • Vitrectomy / methods*

Substances

  • Drug Implants
  • Glucocorticoids
  • Dexamethasone