Intravitreal dexamethasone implant for treatment of persistent postoperative macular edema after vitrectomy

To date, there is no consensus about the management of persistent cystoid macular edema (CME) following vitrectomy. The aim of this study was to evaluate the efficacy and safety of intravitreal dexamethasone implants for the treatment of postoperative CME following vitrectomy. In this multicenter study we retrospectively reviewed the data of 24 patients (25 eyes) who had been treated with intravitreal dexamethasone (OzurdexA (R)) for the management of persistent postoperative CME following pars plana vitrectomy. The main outcome measure was central retinal thickness (CRT in A mu m) as assessed by spectral domain optical coherence tomography (SD-OCT). Secondary outcome measures included change in best corrected visual acuity (BCVA) and the presence of metamorphopsia. All 19 eyes which were postoperatively examined within 4-8 weeks after implantation showed a significant decrease in CRT (mean 564 A mu m to 315 A mu m) and a reduction of metamorphopsias. Within the same period of time the BCVA improved in 15 out of 19 eyes (79%) which corresponds to an average visual improvement from 0.69 logMAR to 0.46 logMAR (P < 0.0001). In eyes examined after 10-16 weeks a slight increase in the average CRT of 351 A mu m was observed, whereas the BCVA improved to 0.28 logMAR. After 4 months a decrease in average BCVA was noted. Out of 25 eyes 12 required further dexamethasone implantations between 1 and 4 times within the investigation period. The first repeat injections were performed an average of 7.3 months after the initial treatment. Our results suggest that intravitreal dexamethasone is a safe and effective treatment option for persistent CME following vitrectomy.