Efficacy of Intravitreal Dexamethasone Implantation (Ozurdex) Combined with Transconjunctival Sutureless Vitrectomy for Refractory Diabetic Macular Edema


SCIENTIFIC POSTER

Efficacy of Intravitreal Dexamethasone Implantation (Ozurdex) Combined with Transconjunctival Sutureless Vitrectomy for Refractory Diabetic Macular Edema by Younghoon Lee, South Korea


ABSTRACT

Purpose:

To evaluate the efficacy of intravitreal dexamethasone implantation (Ozurdex®) combined with transconjunctival sutureless vitrectomy for refractory diabetic macular edema.

Methods:

A retrospective review of medical records was performed for 26 patients (26 eyes) who were diagnosed as refractory diabetic macular edema which persisted despite previous nonsurgical treatment for more than 6 months. Patients underwent 25-gauge transconjunctival sutureless vitrectomy and intraoperative dexamethasone implant injection. Best corrected visual acuity (BCVA, logMAR), central macular thickness (CMT) and intraocular pressure were assessed postoperatively.

Results:

All patients had received at least one of the treatments commonly used in the management of DME. 18 patients underwent focal or grid laser treatment, mean 4.2 times intravitreal bevacizumab injections (1.25mg/0.05mL), 1.63 times subtenon triamcinolone injection (20mg/0.5mL), and 0.76 times intravitreal triamcinolone injection (4mg/0.1mL). Mean preoperative BCVA and CMT were 0.66 ± 0.21 and 481.19 ± 71.26 μm. After vitrectomy, mean BCVA was significantly improved to 0.42 ± 0.17 (p<0.001), 0.38 ± 0.20 (p<0.001), 0.39 ± 0.19 (p<0.001), 0.40 ± 0.16 (p<0.001), 0.41 ± 0.22 (p=0.001) at 1, 3, 4, 6months and the final visit, respectively. CMT was decreased to 364.12 ± 59.60 μm (p<0.001), 328.38 ± 69.97 μm (p<0.001), 362.92 ± 74.24 μm (p<0.001), 351.15 ± 69.51 μm (p<0.001), 344.00 ± 71.72 μm (p<0.001) at 1, 3, 4, 6months and the final visit, respectively. Baseline IOP was 14.77 ± 2.18 mmHg, which were 15.31 ± 3.33 mmHg, 15.15 ± 3.54 mmHg, 14.58 ± 3.90 mmHg, 14.35 ± 3.57 mmHg, 14.73 ± 3.46 mmHg at 1, 3, 4, 6months and the final visit, respectively, and no there were significant differences. Two patients had elevated intraocular pressure but controlled with eye drops. No other adverse events were reported in the study eyes.

Conclusion:

Intravitreal dexamethasone implantation (Ozurdex®) combined with transconjunctival sutureless vitrectomy was effective and safe treatment option in patients with refractory diabetic macular edema which persisted despite previous nonsurgical treatment.


CONTACT DETAILS

 

Younghoon Lee
Daejeon, South Korea
Email : astrix001@gmail.com
Cell Phone: +821034100329
Work Phone: +821034100329