June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Safety and outcomes of intraoperative intravitreal injection of dexamethasone after air-fluid exchange in pars plana vitrectomy for diabetic retinopathy
Author Affiliations & Notes
  • Nish Patel
    Ophthalmology, Henry Ford Hospital, Detroit, Michigan, United States
  • Sachin Ketkar
    Wayne State University School of Medicine, Detroit, Michigan, United States
  • Venkatkrish Kasetty
    Ophthalmology, Henry Ford Hospital, Detroit, Michigan, United States
  • Tyler Looysen
    Ophthalmology, Henry Ford Hospital, Detroit, Michigan, United States
  • Abdualrahman Hamad
    Ophthalmology, Henry Ford Hospital, Detroit, Michigan, United States
  • Footnotes
    Commercial Relationships   Nish Patel None; Sachin Ketkar None; Venkatkrish Kasetty None; Tyler Looysen None; Abdualrahman Hamad None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 2180 – F0243. doi:
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      Nish Patel, Sachin Ketkar, Venkatkrish Kasetty, Tyler Looysen, Abdualrahman Hamad; Safety and outcomes of intraoperative intravitreal injection of dexamethasone after air-fluid exchange in pars plana vitrectomy for diabetic retinopathy. Invest. Ophthalmol. Vis. Sci. 2022;63(7):2180 – F0243.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Endolaser (EL) can cause significant inflammation as well as serous choroidal and retinal detachments. A 2003 study noted improvement in postoperative (PO) inflammation after a single intravitreal injection of dexamethasone (DEX) following pars plana vitrectomy (PPV). However, none of these patients underwent air-fluid exchange (AFE). We aim to determine the safety and efficacy of intraoperative intravitreal injection of DEX after AFE in PPV with EL for diabetic retinopathy (DR).

Methods : A retrospective consecutive study was conducted over a one-year period. 23 eyes (21 patients) met inclusion criteria for the study: subjects 18 years of age or older who intraoperatively received a single intravitreal injection of DEX (0.2 mg) after PPV with AFE and EL for DR complications. Data analysis was performed with SAS 9.4 (SAS Institute Inc, Cary, NC, USA).

Results : The mean logMAR best corrected visual acuity (BCVA) at the pre-operative visit was 1.45 (median=1.30, SD=1.03). Twenty-two (95.7%) eyes had an intraocular pressure (IOP) in the normal range (0- 21) at this visit, and one eye had an IOP of 25. No eyes had significant anterior chamber (AC) inflammation prior to PPV. After AFE, two (8.7%) eyes were left under C3F8 gas, one (4.3%) under SF6 gas, and two (8.7%) under silicone oil (SO). Median improvement in BCVA was noted at the PO one month (-0.7, p=0.0277) and three month (-0.9, p=0.0150) visits. Seventeen (94.4%) eyes had an IOP in the normal range at the three month PO visit; one (5.6%) had an IOP of 22. No eyes demonstrated significant AC inflammation at the PO one and three month visits. Three (13.0%) eyes required an intravitreal injection within six months after PPV. The mean central retinal thickness per optical coherence tomography was 367.61 μm (median=302.0, SD=181.9) at a mean PO period of 153.7 days (median=174.00, SD=64.3). Five (21.7%) eyes exhibited choroidal detachments on PO day one; all of which self-resolved by week one. Three (13.0%) eyes underwent repeat PPV: one for proliferative vitreoretinopathy, one for vitreous hemorrhage, and one for SO removal.

Conclusions : A single intravitreal injection of DEX after PPV with EL and AFE appears to be safe. Further studies comparing groups that receive intravitreal DEX to those that do not are warranted to assess the effectiveness of this intervention in improving PO outcomes.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

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