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Sunil K Srivastava, Kimberly Baynes, Peter K Kaiser, Daniel F Martin, Rishi P Singh, Justis P Ehlers; Ozurdex for macular Edema due to epiretinal membrane treated with Pars plana vitrEctomy and membrane RemovAl (OPERA). Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):5047.
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The Ozurdex implant is approved for use in the treatment of uveitis and macular edema due to retinal vein occlusion and diabettic retinopathy. Previous studies have illustrated the ability of the implant to reduce macular edema in eyes with a history of vitrectomy. We sought to assess the use of intravitreal dexamethasone implant (Ozurdex) at the time of pars plana vitrectomy for macular edema due to epiretinal membranes. This analysis is a planned interim 6 month results
This was an IRB approved prospective open label study. Inclusion critieria included patients with epiretinal membranes associated with and without diabetic macular edema whom were undergoing pars plana vitrectomy. Exclusion criteria included those with macular edema from other causes including age-related macular degeneration and retinal vein occlusion, glaucoma, aphakia, patients with anterior chamber IOL. Patients were injected after vitrectomy and then followed on a monthly basis. Retreatment could occur with increase in macular edema or loss of vision. Baseline OCT and ETDRS vision was obtained on all patients. Follow-up OCT and VA were obtained at month 1,2,3,4,6,8,10,12.
A total of 23 patients have been enrolled. 13 patients had at least 6 month data for analysis. Mean baseline visual acuity measured 56 letters and mean central retinal thickness measured 462 um. At month 6 mean vision had improved to 65 letters (p=.039) and mean central retinal thickness had decreased to 365 um (p=.02). There was rapid improvement in macular edema by month 1, however, vision slowly improved over the first 6 months. One patient required short term topical therapy for elevated intraocular pressure. 1 patient had the implant attached to macular area post-operatively in a eye with gas fill which required additional surgery. There were no other adverse events.
Patients treated with Ozurdex at the time of pars plana vitrectomy for epiretinal membranes with macular edema had improvements in visual acuity and reduction in central retinal thickness by month 6. The rates of intraocular pressure elevation were low. The implant procedure was well tolerated. Caution should be exercised in patients with full gas fills to avoid attachment to the macular area.
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