This retrospective study was aimed to compare intravitreal dexamethasone implant and posterior subtenon triamcinolone injection (PSTA) in the treatment of diabetic macular edema (DME) in vitrectomised eyes. Sixty-four (48.12%) patients who had received PSTA and 69 (51.88%) patients who had received DEX implants in DME treatment after vitrectomy were included in the study. Best corrected visual acuity (BCVA), central macular thickness (CMT), and intraocular pressure (IOP) pre injection; and at one, three and six months post injection were reviewed and statistically compared. All post-injection CMT values in both groups were lower than the pre-injection value (p < 0.05 for all). There were statistically significant increases in all post-injection BCVAs of the DEX group and post-injection one-month BCVA of the PSTA group (p < 0.05 for all). However, there was no significant difference in BCVA values of the PSTA group at three and six months after injection (p > 0.05 for both). There was no statistically significant difference in all post-injection IOP values of the PSTA group (p > 0.05 for all). Significant increases in IOP were observed in the DEX group at one and three months after injection (p < 0.05 and p = 0.02, respectively). The number of additional injections between the third and sixth months after the initial injection was statistically higher in the PSTA group (p = 0.006). The study concluded that both intravitreal DEX and PSTA administration are effective in the treatment of DME after vitrectomy. However, visual improvement was maintained longer, and the need for additional injections was less in patients who received DEX. Post-injection IOP elevation in the DEX group can occur, however this can be controlled with medical therapy. Limitations: Retrospective design and small number of patients.
Treatment of diabetic macular edema in vitrectomised eyes – comparison of intravitreal dexamethasone implant and posterior subtenon triamcinolone injection
Reviewed by Sofia Rokerya
Comparison of intravitreal dexamethasone implant and posterior subtenon triamcinolone injection in the treatment of diabetic macular edema in vitrectomized eyes.
CONTRIBUTOR
Sofia Rokerya
MBBS MRCOphth FRCSI, King's College University Hospital, UK.
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