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DOI: 10.1055/s-0042-122384
Intraocular Dexamethasone Implant as Adjunct to Silicone Oil Tamponade for Proliferative Vitreoretinopathy
Intraokulares Dexamethasonimplantat mit Silikonöltamponade für proliferative VitreoretinopathiePublication History
Publication Date:
01 February 2017 (online)
Abstract
Background Proliferative vitreoretinopathy (PVR) occurs in 10 % of patients with retinal detachment and is characterized by excessive epi-, sub- or intraretinal contraction. Corticosteroids have been shown to counter this contraction.
Patients and Methods Retrospective review of 5 patients (3 females, 2 males) with recurrent retinal detachment with stage C PVR. The mean age was 61.2 ± 20.5 years and myopia > − 5.0 dioptres was present in 3 eyes. Patients were treated with 23 g vitrectomy, retinectomy and endolaser, dexamethasone (Ozurdex®) injection under perfluorocarbone and 5500 cs silicone oil tamponade.
Results After a total follow-up of 8.8 ± 6.4 months with silicone oil tamponade, the Ozurdex® implant was localised in the macula in 1 case, and in 4 cases behind the iris with a completely attached retina. Preoperative intraocular pressure was 11.0 ± 4.0 mmHg, which remained stable at 7.8 ± 3.5 mmHg at the end of the final follow-up. No localised adverse effects were observed of the implant on the retina or the iris.
Conclusions The dexamethasone implant Ozurdex® is well tolerated in conjunction with silicone oil tamponade in eyes with retinal detachment and PVR. The implant may be a potential candidate for the prevention of PVR.
Zusammenfassung
Hintergrund Proliferative Vitreoretinopathie (PVR) tritt in 10 % der Patienten mit Netzhautablösung auf und ist durch epi-, sub- und intraretinale Vernarbungen charakterisiert. Steroide können diese Kontraktion reduzieren.
Patienten und Methoden Retrospektive Übersicht von 5 Patienten (3 F, 2 M) mit Netzhautablösung mit PVR-Stadium C. Das Durchschnittsalter war 61,2 ± 20,5 Jahre mit einer Myopie von > − 5.0 Dioptrien in 3 Fällen. Patienten wurden mittels 23 g Vitrektomie, Retinektomie, Endolaser, Dexamethason-Injektion (Ozurdex®) unter Perfluorocarbon und 5500 cs Silikonöltamponade operiert.
Ergebnisse Nach einer Nachkontrolle von 8.8 ± 6.4 Monaten unter Silikonöltamponade war die Netzhaut in allen Fällen anliegend. Das Ozurdex®-Implantat war in 1 Fall in der Makula und in 4 Fällen hinter der Iris lokalisiert. Der präoperative intraokulare Druck betrug 11.0 ± 4.0 mmHg und am Ende der gesamten Nachkontrolle 7.8 ± 3.5 mmHg. An der Netzhaut und an der Iris konnten keine lokalisierten Nebeneffekte des Implantats beobachtet werden.
Schlussfolgerungen Das Dexamethasonimplantat Ozurdex® wird unter Silikonöltamponade für PVR gut toleriert. Das Implantat könnte in Zukunft ein potenzieller Kandidat für die Prävention der PVR sein.
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References
- 1 Pastor JC, Rojas J, Pastor-Idoate S. Proliferative vitreoretinopathy: A new concept of disease pathogenesis and practical consequences. Prog Retin Eye Res 2016; 51: 125-155
- 2 Machemer R, Sugita G, Tano Y. Treatment of intraocular proliferations with intravitreal steroids. Trans Am Ophthalmol Soc 1979; 77: 171-180
- 3 Turkoz Y, Er H, Borazan M. et al. Use of caffeic acid phenethyl ester and cortisone may prevent proliferative vitreoretinopathy. Mediators Inflamm 2004; 13: 127-130
- 4 Kuo HK, Chen YH, Wu PC. et al. The effects of Ozurdex® (dexamethasone intravitreal implant) on experimental proliferative vitreoretinopathy. Ophthalmologica 2015; 233: 198-203
- 5 Ahmadieh H, Feghhi M, Tabatabaei H. et al. Triamcinolone acetonide in silicone-filled eyes as adjunctive treatment for proliferative vitreoretinopathy: a randomized clinical trial. Ophthalmology 2008; 115: 1938-1943
- 6 Shi H, Guo T, Liu PC. et al. Steroids as an adjunct for reducing the incidence of proliferative vitreoretinopathy after rhegmatogenous retinal detachment surgery: a systematic review and meta-analysis. Drug Des Devel Ther 2015; 9: 1393-1400
- 7 Koerner F, Koerner-Stiefbold U, Garweg JG. Systemic corticosteroids reduce the risk of cellophane membranes after retinal detachment surgery: a prospective randomized clinical trial. Graefes Arch Clin Exp Ophthalmol 2012; 250: 981-987
- 8 Kim JT, Yoon YH, Lee DH. et al. Dexamethasone intravitreal implant in the silicone oil-filled eye for the treatment for recurrent macular oedema associated with ankylosing spondylitis: a case report. Acta Ophthalmol 2013; 91: e331-e332
- 9 Banerjee P, Bunce C, Charteris DG. Ozurdex® (a slow-release dexamethasone implant) in proliferative vitreoretinopathy: study protocol for a randomised controlled trial. Trials 2013; 14: 358
- 10 Banerjee PJ, Petrou P, Zvobgo TM. et al. Spontaneous relocation of a trapped retrolenticular slow-release dexamethasone implant (Ozurdex) in a silicone oil-filled eye of a pseudophakic patient. Eye (Lond) 2014; 28: 1036-1037
- 11 Sivaprasad S, McCluskey P, Lightman S. Intravitreal steroids in the management of macular oedema. Acta Ophthalmol Scand 2006; 84: 722-733
- 12 Chang-Lin JE, Mayssa A, Acheampong AA. et al. Pharmacokinetics and pharmacodynamics of a sustained-release dexamethasone intravitreal implant. Invest Ophthalmol Vis Sci 2011; 52: 80-86
- 13 Gan IM, Ugahary LC, van Dissel JT. et al. Effect of intravitreal dexamethasone on vitreous vancomycin concentrations in patients with suspected postoperative bacterial endophthalmitis. Graefes Arch Clin Exp Ophthalmol 2005; 243: 1186-1189