Evaluation of intraoperative slow-release dexamethasone implant combined with idiopathic epiretinal membrane removal
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Evaluation of intraoperative slow-release dexamethasone implant combined with idiopathic epiretinal membrane removal Alfonso Savastano 1,2 & Alice Bitossi 3 & Fabrizio Giansanti 3 & Lorenzo Vannozzi 3 & Tomaso Caporossi 3 & Francesco Barca 3 & Gianni Virgili 3 & Gloria Gambini 1 & Umberto De Vico 1 & Patrizio Bernardinelli 1,2 & Maria Cristina Savastano 1,2 & Stanislao Rizzo 1,2,4 Received: 18 April 2020 / Revised: 19 August 2020 / Accepted: 25 August 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose To evaluate the efficacy of intraoperative slow-release dexamethasone implant (DEX) combined with removal of idiopathic epiretinal membrane (ERM). Methods In this observational retrospective study, data of 40 patients with phakic eyes affected by idiopathic ERM were analysed. All patients underwent cataract phacoemulsification, 25-gauge (G) pars plana vitrectomy (PPV), ERM removal with DEX implant (“DEX YES” group, #20) or without DEX implant (“DEX NO” group, #20). We collected data on best-corrected visual acuity (BCVA) < 20/40 Snellen charts, central macular thickness (CMT) ≤ 400 μm (measured by SD-OCT) and integrity of sub-foveal ellipsoid/myoid zone. BCVA, CMT and intraocular pressure (IOP) were evaluated at baseline as well as 15, 30 and 90 days after surgery. Results In the “DEX YES” group, statistically significant BCVA improvement was observed at 15, 30 and 90 days (p < 0.001), while in the “DEX NO” group, improvements were observed only at 30 and 90 days (p < 0.001). In both groups, CMT significantly decreased at each follow-up visit (p < 0.001), and no statistically significant increase of IOP was detected at each follow-up visit. Conclusions In this study, DEX accelerated the improvement of BCVA at 15 days after surgery. However, no evidence of further anatomical (CMT) and functional (BCVA) DEX effectiveness combined with removal of idiopathic ERM by 25-G PPV at 30 and 90 days follow-up was observed. Keywords Epiretinal membrane . Intravitreal dexamethasone . Macular pucker . Vitrectomy . Personalized medicine . Innovative biotechnology
Introduction Epiretinal membranes (ERMs) are a non-vascularized fibrocellular contractile proliferation, composed of accessory retinal glial cells, fibrous astrocytes and Müller cells, which
form over the surface of the internal limiting membrane (ILM) in the macular area [1, 2]. Iwanoff first described them in 1865, and Gass proposed an ophthalmoscopic classification [3, 4]. The spectral-domain optical coherence tomography (SD-OCT) has allowed clinicians to more accurately diagnose
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00417-020-04911-5) contains supplementary material, which is available to authorized users. * Alfonso Savastano [email protected] 1
2
Unit of Ophthalmology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy Catholic University of “Sacro Cuore”, Rome, Italy
3
Department of Surgery
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