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Mostafa Alam; Recalcitrant cystoid macular edema after pars plana vitrectomy. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):5116.
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© ARVO (1962-2015); The Authors (2016-present)
The purpose of this study is to evaluate the efficacy and safety outcomes of different types of treatment for chronic cystoid macular edema ( CME ) after pars plana vitrectomy.
This was a retrospective review of eyes that developed chronic, recalcitrant CME after vitreoretinal surgery. The therapy consisted of initial TCA and in non responding eyes Bevacizumab was added. Data included patient age, sex, eye laterality, indication for surgery, and duration between the surgery and onset of CME; baseline preoperative clinical data including best-corrected visual acuity (BCVA), central foveal thickness (CFT) and intraocular pressure (IOP), the follow up lasted 1 year, postoperative data including IOP, BCVA, CFT, at months 1, 3, 6 and 12, and occurrence of postoperative complications.
A total of 39 eyes of 37 patients with chronic, recalcitrant post-PPV CME were included in the review and analysis of data. Statistical analysis showed that for the TCA alone treated group, there was improvement in vision at 1 month (p=0.0537) and reduction in thickness at 3 and 12 months (p=0.0416 and 0.0104, respectively).<br /> For the combined TCA + bevacizumab group, no significant differences were noted between baseline and months 1, 3, 6, and 12 months for CFT, VA, and IOP.
Chronic CME after pars plana vitrectomy is difficult to treat and usually recurs.<br /> Intravitreal TCA is often initially effective in reducing the macular edema with visual acuity improvement. Resistant cases (28.2%) did not respond to the combined treatment. Even with repeated injections, IOP did not significantly rise with the use of prophylactic anti-glaucoma drops.
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