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Markus Ritter, Stefan Sacu, Gerlinde Matt, Roman Dunavoelgyi, Wolf Buehl, Christian Pruente, Ursula Schmidt-Erfurth; Effect of Systemic Steroid after Successful Macular Surgery in Eyes with Epiretinal Membrane : Long Term Results of a Randomized Study. Invest. Ophthalmol. Vis. Sci. 2011;52(14):2142.
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To evaluate the functional and morphological outcomes of postoperative systemic steroid therapy after successful macular surgery in eyes with macular edema due to idiopathic macular epiretinal membranes (ERM).
Twenty-eight patients scheduled for 23-gauge vitrectomy combined with ERM and inner limiting membrane (ILM) peeling for macular edema due to ERM were included in this prospective, randomized, controlled clinical study. Patients were randomized to receive oral steroid therapy (Prednisolon, 100 mg per day for 5 days) or no oral steroid (control group) after surgery. Main outcome measures included best corrected visual acuity (ETDRS), central retinal thickness (CRT), retinal volume (RV) and macular morphology as determined by spectral domain OCT (SD-OCT, Cirrus). Examinations were carried out preoperatively and at week 1, month 1, month 3, month 6 and month 12 postoperatively.
At month 12, mean BCVA improved to a 9 letters gain in the steroid group and a 8 letters gain in control group (p<0.01 compared to baseline for both groups) showing no statistically significant difference between both groups (p=0.19). Morphologically, retinal surface folds resolved within 1 month after surgery in both treatment groups, followed by a progressive recovery of retinal layer integrity and a statistical significant (p<0.01 ) decrease in CRT and RV without significant differences between both groups (p=0.62, p=0.13 respectively, ANOVA between the groups). 7 (64%) of the 11 phacic eyes in the steroid group and 5 (38%) of the 13 phacic eyes in the control group had worsening of cataracts during the follow-up period and underwent cataract surgery.
The early postoperative use of systemic steroid treatment after successful vitrectomy combined with ERM and ILM peeling doesn’t seem to improve significantly the anatomic and functional outcomes in eyes with ERM.
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