Dexamethasone Intravitreal Implant For Macular Edema Secondary To Vitrectomy For Epiretinal Membranes

Objectives:To investigate the efficacy of Dexamethasone Intravitreal Implant(DEX)in the treatment of Macular Edema(ME)after Idiopathic Epiretinal Membrane(IERM)vitrectomy.Methods:This study retrospectively analyzed during January 2019-January 2021 in the second affiliated hospital of Nanchang university diagnosis of postoperative patients with macular edema in 48 cases and 48 eyes,who are conducted by i ERM has 23 G vitrectomy combined ILM removal and cataract phacoemulsification and intracapsular intraocular lens implantation,within vitrectomy 4 to 12 weeks,the follow-up patients diagnosed with ME and met inclusion criteria,including 16 cases of male,female 32 cases,average age 67.65±6.64.According to the patients’ will,they were divided into injection group and control group.The injection group received intravitreous injection of DEX implant 0.7mg(Ireland;Allergan Pharmaceuticals Ireland),a total of 24 patients and 24 eyes(7 males,17 females,average age67.83±7.04 years old);The control group which consisted of 24 patients and 24 eyes(9 males,15 females,average age 67.46±6.35 years)were observed without intervention.The patient’s best corrected visual acuity(BCVA),central macular foveal thickness(CMT),and intraocular pressure(IOP)were used as baseline when diagnosed with Macular edema at follow-up.After 6 months of follow-up,BCVA,CMT and IOP,as well as the incidence of related adverse complications,were observed and recorded in each patient whoever was in the injection group or in the control group at 1 week,1 month,3 months and 6 months.BCVA was examined using international standard visual acuity charts and converted to minimum resolved Angle log(Log MAR)acuity for statistical analysis.Results:1.There were no significant differences in age,gender,baseline BCVA(Log MAR),baseline CMT and IOP between the two groups(P >0.05).2.In the control group,compared with the baseline CMT at each time point during the follow-up period,there was no significant difference in the average CMT at week 1 and month 1(P >0.05).While the difference was statistically significant at month 3 and month 6(P<0.05).3.In the injection group,the average CMT at each time point during the follow-up period was statistically significant compared with the baseline CMT(P<0.05),especially,there were significant differences in the 1st month,3rd month and 6th month(P< 0.01).4.The difference between the mean CMT and baseline CMT at each time point of follow-up between the two groups was compared(ΔCMT).At week 1,month 1,month 3 and month 6,there were significant statistical differences between the two groups(P<0.01 in all comparisons).5.At the end of six months of follow-up,patients in both groups had improved on average in BCVA.In the control group,there was no significant improvement in the mean BCVA of the previous week compared with baseline(P>0.05).Mean BCVA improved significantly from baseline at month 3 and month 6(P<0.05).6.In the injection group,the mean BCVA at each time point during the follow-up period was significantly improved compared with the baseline BCVA(P<0.05).7.The difference between the mean BCVA and baseline BCVA at each follow-up time point between the two groups was compared(ΔBCVA(Log MAR)),there were statistically significant differences between the two groups at each time point(P<0.01 for all comparisons).8.There was no statistically significant difference in IOP between the two groups before and after surgery(P>0.05 in all comparisons).And no complications occurred in both groups during follow-up.Conclusions:Dexamethasone implant can reduce the thickness of macular fovea and improve visual acuity,Which is a safe and effective method for the treatment of macular edema after PPV for ERM removal.