Vitrectomy combined with intraoperative dexamethasone implant for the management of refractory diabetic macular edema
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Purpose: To evaluate the 1-year results of vitrectomy performed in combination with intraoperative dexamethasoneimplant for tractional and nontractional refractory diabetic macular edema (DME). Methods: Thirteen eyes from 13 subjects who were diagnosed with tractional DME and 17 eyes from 17 subjectswho were diagnosed with nontractional refractory DME underwent vitrectomy and dexamethasone implantinjection. Changes in best-corrected visual acuity (BCVA) and central macular thickness (CMT) duringthe one year following vitrectomy were evaluated in each group. Additionally, changes in intraocular pressureand other complications were investigated postoperatively. Results: In eyes with tractional DME, a statistically significant improvement in BCVA was noted at 3, 6, and 12months, and a statistically significant improvement in CMT was noted at 1, 3, 6, and 12 months from baselineafter vitrectomy (p < 0.05). In eyes with nontractional refractory DME, a statistically significant improvementin BCVA was noted at 12 months, but there were no significant improvements in CMT despite the tendencyto decrease from baseline. Sixteen (53.3%) of the 30 eyes included in this study showed intraocular pressureelevation, which was addressed using antiglaucoma medication, and there were no other severe complications. Conclusions: Vitrectomy combined with intraoperative dexamethasone implant may be safe and effective intreating DME, especially tractional DME. In this study, patients with nontractional DME required more additionaltreatments and time for anatomical and functional improvement compared to patients with tractionalDME.
Abstract
Purpose: To evaluate the 1-year results of vitrectomy performed in combination with intraoperative dexamethasoneimplant for tractional and nontractional refractory diabetic macular edema (DME). Methods: Thirteen eyes from 13 subjects who were diagnosed with tractional DME and 17 eyes from 17 subjectswho were diagnosed with nontractional refractory DME underwent vitrectomy and dexamethasone implantinjection. Changes in best-corrected visual acuity (BCVA) and central macular thickness (CMT) duringthe one year following vitrectomy were evaluated in each group. Additionally, changes in intraocular pressureand other complications were investigated postoperatively. Results: In eyes with tractional DME, a statistically significant improvement in BCVA was noted at 3, 6, and 12months, and a statistically significant improvement in CMT was noted at 1, 3, 6, and 12 months from baselineafter vitrectomy (p < 0.05). In eyes with nontractional refractory DME, a statistically significant improvementin BCVA was noted at 12 months, but there were no significant improvements in CMT despite the tendencyto decrease from baseline. Sixteen (53.3%) of the 30 eyes included in this study showed intraocular pressureelevation, which was addressed using antiglaucoma medication, and there were no other severe complications. Conclusions: Vitrectomy combined with intraoperative dexamethasone implant may be safe and effective intreating DME, especially tractional DME. In this study, patients with nontractional DME required more additionaltreatments and time for anatomical and functional improvement compared to patients with tractionalDME.
참고문헌 (36)
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