Comparison of Dexamethasone Intravitreal Implant with Conventional Triamcinolone in Patients with Postoperative Cystoid Macular Edema.
To evaluate the efficacy of the treatment with intravitreal triamcinolone acetonide or dexamethasone intravitreal implant in patients with postoperative cystoid macular edema (PCME).



Thirty eyes of 29 patients with PCME were randomized into two groups: one group initially received an injection of 4 mg triamcinolone; retreatment after 3 months was dependent on functional and anatomic outcome in a PRN regimen. The second group received a single injection of the dexamethasone intravitreal implant (Ozurdex). Patients were followed for 6 months. The main outcomes were best-corrected visual acuity (BCVA) and central millimeter retinal thickness (CMMT).



Mean BCVA improved significantly in both groups at 3 months (p ≤ 0.05) and 6 months (p ≤ 0.05) after treatment. There was no statistically significant difference between the two groups in visual acuity improvement at 3 months (p > 0.05) or 6 months (p > 0.05). Mean CMMT of both groups also decreased significantly after treatment at 3 and 6 months (both p ≤ 0.05) and the reduction was significantly superior in the triamcinolone group compared to ozurdex group at 1 week and 6 months (p ≤ 0.05). All cases with intraocular hypertension were managed with IOP-lowering medication and no surgery was required during the study. One patient was excluded because of endophthalmitis in the triamcinolone group.



Intravitreal triamcinolone and dexamethasone implant are both equally effective in increasing visual acuity in patients with PCME at a 6-month follow-up. However, macular edema seems to respond more rapidly with intravitreal triamcinolone, and 3-monthly repetitive injections maintain the reduction in retinal thickness better than a single dexamethasone implant at the first 6 months of follow-up period.
a Department of Ophthalmology , Medical University of Vienna , Vienna , Austria.
Georgios
G
Mylonas
a Department of Ophthalmology , Medical University of Vienna , Vienna , Austria.
Michael
M
Georgopoulos
b 1st Department of Ophthalmology , "G. Gennimatas" General Hospital of Athens, University of Athens , Athens , Greece.
Panagiotis
P
Malamos
b 1st Department of Ophthalmology , "G. Gennimatas" General Hospital of Athens, University of Athens , Athens , Greece.
Ilias
I
Georgalas
b 1st Department of Ophthalmology , "G. Gennimatas" General Hospital of Athens, University of Athens , Athens , Greece.
Chryssanthi
C
Koutsandrea
b 1st Department of Ophthalmology , "G. Gennimatas" General Hospital of Athens, University of Athens , Athens , Greece.
Dimitrios
D
Brouzas
a Department of Ophthalmology , Medical University of Vienna , Vienna , Austria.
Stefan
S
Sacu
c Department of Cranio-, Maxillofacial and Oral Surgery , Medical University of Vienna , Vienna , Austria.
Christos
C
Perisanidis
a Department of Ophthalmology , Medical University of Vienna , Vienna , Austria.
Ursula
U
Schmidt-Erfurth
D000368:Aged; D000369:Aged, 80 and over; D003907:Dexamethasone / Q000008:administration & dosage*; D004343:Drug Implants; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D058449:Intravitreal Injections; D008269:Macular Edema / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D008297:Male; D011183:Postoperative Complications / Q000188:drug therapy*; D011446:Prospective Studies; D012160:Retina / Q000473:pathology; D019233:Retreatment; D041623:Tomography, Optical Coherence; D014222:Triamcinolone Acetonide / Q000008:administration & dosage*; D014792:Visual Acuity / Q000187:drug effects
D004343:Drug Implants; D005938:Glucocorticoids; D003907:Dexamethasone; D014222:Triamcinolone Acetonide
Ozurdex; Postoperative cystoid macular edema; dexamethasone implant; intravitreal triamcinolone acetonide