Transoperative intravitreal dexamethasone implantation in patients with proliferative vitreoretinopathy.

Jeniffer Trenado-Luna, Gerardo Rivera-Arroyo, Elizabeth Baqués-Guillén, César Ramos-Roldán, José Ma Arroyo-González, Lucila García-Chávez, José F Valdez-López, Pedro Escalera-Arroyo
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Abstract

Objective: To compare the anatomical results in patients with rhegmatogenous retinal detachment, at least grade B of proliferative vitreoretinopathy, and with a trans-surgical dexamethasone implant vs the control group. We also assessed the diminution of proliferative vitreoretinopathy and the final visual acuity (VA).

Method: The patients were evaluated clinically and with optical coherence tomography for 10 months. Logistic regression analyses were performed to evaluate the effect of the dexamethasone implant on retinal detachment. Correlational analyses were explored depending on the variables' distribution, and an independent samples t-test was used to compare the VA in both groups.

Results: The study included 38 eyes of patients with proliferative vitreoretinopathy: 18 with the implant and 20 for the control group. The evaluation of the main objective showed significant differences (p < 0.05) in the anatomical success between the two groups (61.1% vs. 20%, treatment vs. control); odds ratio of 6.29; 95% confidence interval: 1.5- 26.8; p = 0.013; Nagelkerke's R2 = 0.225. The t-test showed a significant difference in the final VA of the patients (t = 2.047; df = 36; p = 0.048; Cohen's d = 0.66).

Conclusions: Retinal redetachment was less frequent, and better VA was observed, in patients with the dexamethasone implant in comparison with the control group.

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增殖性玻璃体视网膜病变患者的玻璃体内地塞米松植入术。
目的:比较孔源性视网膜脱离(至少B级增殖性玻璃体视网膜病变)患者和经手术植入地塞米松的患者与对照组的解剖结果。我们还评估了增殖性玻璃体视网膜病变的减少和最终视力(VA)。方法:对患者进行临床评估,并用光学相干断层扫描进行10个月的评估。进行Logistic回归分析,以评估地塞米松植入物对视网膜脱离的影响。根据变量的分布进行相关性分析,并使用独立样本t检验来比较两组的VA。结果:本研究包括38眼增生性玻璃体视网膜病变患者:18眼植入,20眼对照组。对主要目标的评估显示,两组之间的解剖成功率存在显著差异(p<0.05)(61.1%vs.20%,治疗组vs.对照组);比值比6.29;95%置信区间:1.5-26.8;p=0.013;Nagelkerke的R2=0.225。t检验显示,患者的最终VA有显著差异(t=2.047;df=36;p=0.048;Cohen’s d=0.66)。结论:与对照组相比,地塞米松植入患者的视网膜再脱离频率较低,VA较好。
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