Real-world experience on intravitreal dexamethasone implant in patients with macular edema scheduled to undergo cataract surgery
Abstract Background Patients with pre-existing macular edema (ME) due to diabetes and retinal vein occlusions (RVO) make up a growing population receiving cataract surgery. Surgery is associated with an increased risk of worsening existing ME due to post-surgical inflammation that can be further exa...
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| Format: | Article |
| Language: | English |
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BMC
2023-08-01
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| Series: | BMC Ophthalmology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12886-023-03093-y |
| _version_ | 1797453513098264576 |
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| author | Chun-Chieh Lai Shu-Chun Kuo |
| author_facet | Chun-Chieh Lai Shu-Chun Kuo |
| author_sort | Chun-Chieh Lai |
| collection | DOAJ |
| description | Abstract Background Patients with pre-existing macular edema (ME) due to diabetes and retinal vein occlusions (RVO) make up a growing population receiving cataract surgery. Surgery is associated with an increased risk of worsening existing ME due to post-surgical inflammation that can be further exacerbated by pre-existing diabetic retinopathy (DR) and retinal vein occlusion. This study aimed to examine the pre-operative use of intravitreal dexamethasone (DEX) implants in patients with ME undergoing cataract surgery. Methods A retrospective study was conducted at National Cheng Kung University Hospital in Taiwan involving 19 eyes of 16 patients with DME or ME associated with RVO. All participants received a DEX implant at baseline and underwent phacoemulsification within 3 months after its insertion. Best-corrected visual acuity (BCVA), intraocular pressure (IOP) and central subfield thickness (CST) were evaluated. Results DEX implants reduced the CST from baseline (357.8 μm) to pre-surgery (280.8 μm). This reduction below baseline continued to month 6 post-surgery (319.4 μm). From baseline (16.15 mmHg), the mean IOP initially increased pre-surgery (17.78 mmHg) before returning to the baseline value at month 6 post-surgery (16.15 mmHg). All patients improved their BCVA from logMAR 0.943 on average at baseline to logMAR 0.532 at month 6 post-surgery. Conclusions The results of the study suggested that patients with ME could benefit from DEX implants before cataract surgery within 3 months to achieve sufficient postoperative inflammation management and limit ME deterioration. DEX implants did not increase IOP post-surgery and was similar to baseline levels. |
| first_indexed | 2024-03-09T15:23:56Z |
| format | Article |
| id | doaj.art-f1a51653a2bf42abae20ffd4719bb35f |
| institution | Directory Open Access Journal |
| issn | 1471-2415 |
| language | English |
| last_indexed | 2024-03-09T15:23:56Z |
| publishDate | 2023-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Ophthalmology |
| spelling | doaj.art-f1a51653a2bf42abae20ffd4719bb35f2023-11-26T12:39:49ZengBMCBMC Ophthalmology1471-24152023-08-012311810.1186/s12886-023-03093-yReal-world experience on intravitreal dexamethasone implant in patients with macular edema scheduled to undergo cataract surgeryChun-Chieh Lai0Shu-Chun Kuo1Department of Ophthalmology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung UniversityDepartment of Ophthalmology, Chi Mei Medical CenterAbstract Background Patients with pre-existing macular edema (ME) due to diabetes and retinal vein occlusions (RVO) make up a growing population receiving cataract surgery. Surgery is associated with an increased risk of worsening existing ME due to post-surgical inflammation that can be further exacerbated by pre-existing diabetic retinopathy (DR) and retinal vein occlusion. This study aimed to examine the pre-operative use of intravitreal dexamethasone (DEX) implants in patients with ME undergoing cataract surgery. Methods A retrospective study was conducted at National Cheng Kung University Hospital in Taiwan involving 19 eyes of 16 patients with DME or ME associated with RVO. All participants received a DEX implant at baseline and underwent phacoemulsification within 3 months after its insertion. Best-corrected visual acuity (BCVA), intraocular pressure (IOP) and central subfield thickness (CST) were evaluated. Results DEX implants reduced the CST from baseline (357.8 μm) to pre-surgery (280.8 μm). This reduction below baseline continued to month 6 post-surgery (319.4 μm). From baseline (16.15 mmHg), the mean IOP initially increased pre-surgery (17.78 mmHg) before returning to the baseline value at month 6 post-surgery (16.15 mmHg). All patients improved their BCVA from logMAR 0.943 on average at baseline to logMAR 0.532 at month 6 post-surgery. Conclusions The results of the study suggested that patients with ME could benefit from DEX implants before cataract surgery within 3 months to achieve sufficient postoperative inflammation management and limit ME deterioration. DEX implants did not increase IOP post-surgery and was similar to baseline levels.https://doi.org/10.1186/s12886-023-03093-yDexamethasone implantDiabetic macular edemaSustained releaseCataractRetinal vein occlusion |
| spellingShingle | Chun-Chieh Lai Shu-Chun Kuo Real-world experience on intravitreal dexamethasone implant in patients with macular edema scheduled to undergo cataract surgery BMC Ophthalmology Dexamethasone implant Diabetic macular edema Sustained release Cataract Retinal vein occlusion |
| title | Real-world experience on intravitreal dexamethasone implant in patients with macular edema scheduled to undergo cataract surgery |
| title_full | Real-world experience on intravitreal dexamethasone implant in patients with macular edema scheduled to undergo cataract surgery |
| title_fullStr | Real-world experience on intravitreal dexamethasone implant in patients with macular edema scheduled to undergo cataract surgery |
| title_full_unstemmed | Real-world experience on intravitreal dexamethasone implant in patients with macular edema scheduled to undergo cataract surgery |
| title_short | Real-world experience on intravitreal dexamethasone implant in patients with macular edema scheduled to undergo cataract surgery |
| title_sort | real world experience on intravitreal dexamethasone implant in patients with macular edema scheduled to undergo cataract surgery |
| topic | Dexamethasone implant Diabetic macular edema Sustained release Cataract Retinal vein occlusion |
| url | https://doi.org/10.1186/s12886-023-03093-y |
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