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panthagani-et-al-2023-intravitreal-dexamethasone-to-manage-post-endothelial-keratoplasty-cystoid-macular-oedema.pdf (445.81 kB)

Intravitreal dexamethasone to manage post endothelial keratoplasty cystoid macular oedema refractory to topical therapy

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journal contribution
posted on 2024-01-08, 14:13 authored by Jesse Panthagani, Elizabeth M Law, Caroline Wong, Chimwemwe Chipeta, Harry Roberts, James Myerscough
Background/Objectives To describe the visual and clinical outcomes of patients with post endothelial keratoplasty (EK) cystoid macular oedema (CMO) refractory to topical treatment with intravitreal sustained-release dexamethasone implant (Ozurdex). Subjects/Methods 131 eyes from 111 patients undergoing solitary or combined EK (52 DSAEK (40.0%) and 79 DMEK (60.0%)) at Southend University Hospital between January 2020 and February 2022 with a minimum follow-up of 6 months were evaluated. Patients suspected of having CMO underwent spectral-domain macular optical coherence tomography (SD-OCT) Patients with diabetes were not included in this series. Results CMO was identified in 5.3% (n = 7) of cases, with 2 of these patients responding to topical corticosteroid treatment. The remaining 5 patients underwent intravitreal dexamethasone implant, with 1 patient requiring repeat implant due to CMO recurrence. All presented within 2 months postoperatively. 4 out of 5 eyes treated with intravitreal dexamethasone achieved a Snellen BCVA ≤6/9.5. 1 patient had an uncontrolled rise in intraocular pressure (IOP) despite maximal medical treatment requiring an urgent PreserFlo Ab-Externo MicroShunt. Conclusions The use of intravitreal sustained-release dexamethasone implant in the management of post EK CMO refractory to topical therapy is effective and safe in most cases, but patients should be monitored and treated promptly for any secondary IOP response.

History

Refereed

  • Yes

Volume

33

Issue number

5

Page range

1903-1910

Publication title

European Journal of Ophthalmology

ISSN

1120-6721

Publisher

SAGE Publications

Location

United States

File version

  • Published version

Language

  • eng

Item sub-type

Journal Article

Media of output

Print-Electronic

Affiliated with

  • Vision and Eye Research Institute (VERI) Outputs