The effect of pars plana vitrectomy with internal limiting membrane peeling on the durability of the intravitreal dexamethasone implant in the treatment of diabetic macular edema

Franzolin, Elia; Gusson, Elena; Panozzo, Giacomo

doi:10.1016/j.ajoc.2022.101401

Cited by 1 publication

(1 citation statement)

References 24 publications

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“…ILM peeling appeared to extend the benefit of the DEX-i in eyes with DME 53 and tDME 28 and reduce the rate of reimplanting 28 . Furthermore, a recent meta-analysis proved that ILM peeling combined with the removal of ERM could reduce the recurrence rate of ERM 54 by eliminating a scaffold for proliferating cells, which could stimulate a leukocyte response in the macular region causing persistent macular edema 55 www.nature.com/scientificreports/ macular edema requiring a second DEX-i was observed for only one patient previously implanted.…”

Section: Discussionmentioning

confidence: 95%

Mid-term safety and effectiveness of macular peeling one month after intravitreal dexamethasone implant for tractional diabetic macular edema

Pignatelli

Niro²,

Fallico³

et al. 2023

Sci Rep

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Macular peeling combined or followed by intravitreal dexamethasone implant (DEX-i) was recommended as an efficacy approach for tractional diabetic macular edema (tDME). Knowing the synergistic effect of cataract surgery and DEX-i one month earlier in eyes with DME, we compared Epiretinal Membrane/Inner Limiting Membrane (ERM/ILM) peeling preceded by DEX-i one month before versus ERM/ILM peeling alone for the treatment of tDME. A retrospective study on patients affected by tDME who underwent ERM/ILM peeling one month after DEX-i (n = 11; Group A) or ERM/ILM peeling alone (n = 10; Group B) was performed. Longitudinal comparison of best-correct visual acuity (BCVA), central retinal thickness (CRT), and intraocular pressure (IOP) between the time of surgery (T0) and each time point (months 1,3,5,6) within and among the groups were assessed. To evaluate the repeated measurements of BCVA, CRT, and IOP, a linear mixed-effects model was used. In Group A, DEX-i significantly improved mean BCVA and CRT (P < 0.001) just after 1 month (T0). After ERM/ILM peeling, mean BCVA and CRT significantly improved from month 1 in Group A and month 3 in Group B. Mixed model revealed a significant difference in BCVA (P ≤ 0.0001) and CRT (P ≤ 0.02) at different time-points among the groups with better results in Group A. Neither complications nor uncontrolled IOP increase was detected. ERM/ILM peeling confirmed its effectiveness in treating tDME. DEX-i performed one month before surgery seemed to be a safe approach and ensured a greater and faster recovery considering functional and tomographic parameters.

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