Intraocular Dexamethasone Implant as Adjunct to Silicone Oil Tamponade for Proliferative Vitreoretinopathy

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.

Key words

Proliferative vitreoretinopathy - vitrectomy - silicone oil - dexamethasone - Ozurdex

Schlüsselwörter

Proliferative Vitreoretinopathie - Vitrektomie - Silikonöl - Dexamethason - Ozurdex

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