Abstract
Purpose :
To compare complications of dexamethasone implants (DEX) and intravitreal triamcinolone (IVTA) in eyes with post-vitrectomy macular edema (ME).
Methods :
A single-center, retrospective study was conducted at Wills Eye Hospital (Philadelphia, PA, USA). 0.7 mg DEX (Ozurdex; Allergan, Inc., Irvine, CA) and 2mg IVTA (Triesence; Alcon Laboratories, Fort Worth, TX) were injected in an office-based clinical setting. The medical records of patients who underwent DEX or IVTA for post-vitrectomy ME between July 2014 and May 2021 with a minimum follow-up of three months were reviewed. We reviewed the following parameters: age, gender, ophthalmic history, pre-treatment and post-treatment visual acuity, and post-treatment ocular complications.
Results :
A total of 125 eyes from 124 patients were included in this study. There were 65 eyes from 65 patients in the DEX group (43% female, mean age 69.7 [±11.5] years) and 60 eyes from 59 patients in the IVTA group (% female, mean age 72.2 [±12.5] years). The total follow-up duration was 2.9 ± 1.7 years, with no significant difference between the two groups (p=0.059). The reasons for prior vitrectomy included rhegmatogenous retinal detachment (RRD), epiretinal membrane, macular hole repair, vitreous hemorrhage, proliferative diabetic retinopathy, retained lens fragments, vitreous opacities, and endophthalmitis. The reasons for DEX and IVTA treatments included post-vitrectomy ME, central retinal vein occlusion, branch retinal vein occlusion, and diabetic ME. The rate of ocular hypotony was significantly higher in the DEX group (9 eyes [14%]) compared with the IVTA group (1 eye [2%]) (p=0.029). The incidence of ocular hypertension was higher in the DEX group (24 eyes [37%]) compared with the IVTA group (12 eyes [20%]) but not statistically significant (p=0.059). There were no between-group differences in the incidence of vitreous hemorrhage (DEX 3 eyes [5%]; IVTA 1 eye [2%]; p=0.669) or RRD (DEX 2 eyes [3%]; IVTA 1 eye [2%]; p=0.944).
Conclusions :
The risk of ocular hypotony was significantly higher and the incidence of ocular hypertension was higher after DEX treatment than after IVTA in eyes with a history of vitrectomy. There were no between-group differences in the other complications.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.