A study compared the efficacy of intracameral dexamethasone to topical corticosteroids after vitreoretinal surgery. The findings were presented at the American Society of Retina Specialists 2021 Annual Meeting.
In this post hoc analysis of a retrospective case-matched comparison, study author Daniel F. Kiernan compared 27 eyes of treated with intracameral dexamethasone at the time of surgery with 27 eyes treated with daily post-operative corticosteroid eye drops over the duration of four weeks. The primary endpoint was the change of optical coherence tomography-measured macular thickness (OCT MT) before and at eight weeks post-operatively. Secondary outcomes were defined as changes in OCT MT pre-operatively and four and 12 weeks post-operatively.
At baseline, the OCT MT was 317 um in the topical steroid-treated group compared to 332 um in the intracameral dexamethasone treatment group (P=0.83). At eight weeks post-operatively, the average OCT MT change was +43.7 um (P=0.0003) in the topical treatment group and -22.4 um (p=0.008) in the intracameral treatment group, the researchers noted.
The results showed that at post-operative weeks four and 12, the topical steroid-treated group had increased OCT MT compared to baseline (36.3 um [P=0002] and 4.67 um [P=0.57], respectively), whereas the intracameral dexamethasone treatment group had decreased OCT MT (-18.78 um [P=0.027] and -22.61 um [P=0.007]). The researchers observed that patients treated with topical steroids for one month after surgery had a higher OCT MT at four and eight weeks post-operatively (51 um [P=0.017] and 53 um [P=0.019]) compared to those who received the intracameral dexamethasone suspension at the time of surgery.
“Intracameral dexamethasone drug-delivery suspension was associated with reduced macular thickness following retinal surgery whereas patients receiving daily topical corticosteroids demonstrated more OCT MT at four and eight weeks post-operatively. These data indicate that this modality may be preferential for preventing post-operative cystoid macular edema compared to topical treatment.
Source: Kiernan D. Effect of Dexamethasone Intracameral Drug-Delivery Suspension Central Retinal Thickness After Vitreoretinal Surgery. Published for ASRS 2021; October 8-12, 2021, San Antonio, TX.