COMBINED VITRECTOMY WITH INTRAVITREAL DEXAMETHASONE IMPLANT FOR REFRACTORY MACULAR EDEMA SECONDARY TO DIABETIC RETINOPATHY, RETINAL VEIN OCCLUSION, AND NONINFECTIOUS POSTERIOR UVEITIS

摘要

Purpose: To compare the efficacy of intraoperative intravitreal dexamethasone implant for macular edema secondary to diabetic retinopathy (DME), retinal vein occlusion (RVO), and noninfectious posterior uveitis. Methods: A retrospective review of 62 patients (29 men and 33 women; mean age 51.19 +/- 14.41 years; 65 eyes) was performed. Best-corrected visual acuity (in logarithm of the minimal angle of resolution), central foveal thickness, intraocular pressure, and postoperative edema-free period were postoperatively assessed up to 1 year. The preoperative and postoperative numbers of other intravitreal injections needed were compared. Results: Best-corrected visual acuity gradually improved in the DME group (from 0.87 to 0.51) but failed to improve from Month 3 onward in the RVO and uveitis groups. Central foveal thickness decreased in all groups, especially in the DME group (from 550.93 to 338.10 mu m). Edema-free period was longest in the DME group (19.34 +/- 15.12 months), followed by the uveitis (12.91 +/- 7.85 months) and RVO (8.50 +/- 8.76 months) groups. Subjects in the uveitis group used more intraocular pressure-lowering agents (1.00 +/- 1.27) than those in the DME (0.13 +/- 0.49) and RVO (0.36 +/- 0.79) groups. Increased intraocular pressure events were most frequent in postoperative Week 1, especially in the uveitis group. Conclusion: Vitrectomy combined with intravitreal dexamethasone implant for DME, RVO, and noninfectious posterior uveitis had a favorable clinical outcome.