Slow-release dexamethasone does not improve success rate of vitrectomy
Adjunctive slow-release dexamethasone implant (Ozurdex) does not improve the outcomes in eyes undergoing vitreoretinal surgery with silicone oil for proliferative vitreoretinopathy (PVR), according to a recent study.
To test the efficacy of Ozurdex, researchers randomized 140 patients requiring vitrectomy surgery with silicone oil for retinal detachment with established PVR (Grade C) to either standard care (control) or study treatment (adjunct; injection of 0.7 mg of slow-release dexamethasone) in a 1:1 allocation ratio.
Of the patients, 138 had primary outcome data (proportion of patients with a stable retinal reattachment with removal of silicone oil without additional vitreoretinal surgical intervention at 6 months.
Anatomic success was similar between the two treatment groups (49.3 vs 46 percent for adjunct and control, respectively; odds ratio, 0.89; 95 percent CI, 0.46 to 1.74; p=0.733).
At 6 months, the mean visual acuity was 38.3 Early Treatment Diabetic Retinopathy Study (ETDRS) letters in the adjunct group and 40.2 ETDRS letters in the control group. Both groups also showed similar secondary anatomic outcomes (complete/posterior reattachment rates and PVR recurrence).
There were also fewer adjunct patients who had cystoid macular oedema (42.7 percent) or a foveal thickness of >300 μm (47.6 percent) compared with controls (67.2 and 67.7 percent, respectively; p=0.004 and p=0.023) at 6 months.
“Further clinical trials are indicated to improve anatomic and visual outcomes in these eyes, but this study suggests that there is a greater reduction in CMO observed at 6 months in vitrectomized eyes treated with slow-release dexamethasone,” researchers said.