Purpose
To report the efficacy of 0.7 mg dexamethasone intravitreal implant in vitrectomized eyes with refractory macular edema secondary to combined vitrectomy with epiretinal membrane removal and phacoemulsification with IOL implantation.
Methods
We report a cases series of 12 eyes with refractory macular edema secondary to combined 23-gauge vitrectomy for epiretinal membrane removal with internal limiting membrane peeling without dying and cataract extraction with IOL implantation. These patients were previously treated for 3 months with NSAIDs, topical corticosteroid and periocular corticosteroid injections and the injection of the 0.7 mg dexamethasone implant was performed if macular edema persisted despite topical treatment. Best-corrected visual acuity, central retinal thickness measured by CIRRUS spectral domain optical coherence tomography, fundus examination and intraocular pressure were evaluated at baseline, 1 month, 2, 3 and 6 months. Cases of ERM secondary to other pathologies (retinal and choroid inflammation, vascular occlusion, ocular trauma, diabetes mellitus, retinal detachment, severe myopia, uveitis,) and age macular degeneration were excluded from the study.
Results
After a mean follow-up of 6.09 ± 0.71 months, mean best-corrected visual acuity was significantly increased (p: 0.003) from 20/100 to 20/50 , mean central retinal thickness decreased from 391 ± 54.5 mc to 335 ± 49.32 mc (p: 0.000), and mean intraocular pressure changed (p: 0.000) from 12.5 ± 1.06 to 16.7 ± 3.01 In no case postoperative complication was observed.
Conclusions
Injection of dexamethasone intravitreal implant resulted effective in the treatment of refractory macular edema secondary to combined cataract extraction and vitrectomy for macular epiretinal membrane removal.