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TRActional DIabetic reTInal detachment surgery with co-adjuvant intravitreal dexamethasONe implant: the TRADITION STUDY.
- Source :
-
Acta diabetologica [Acta Diabetol] 2019 Oct; Vol. 56 (10), pp. 1141-1147. Date of Electronic Publication: 2019 May 14. - Publication Year :
- 2019
-
Abstract
- Aim: Main failure of diabetic tractional retinal detachment (TRD) surgery is the development of proliferative vitreoretinopathy (PVR), causing higher re-detachment rates. We investigated whether the use of dexamethasone (DEX) implant at the end of pars plana vitrectomy (PPV) with silicone oil tamponade might have an impact on these outcomes.<br />Design: Comparative, nonrandomized, retrospective study.<br />Participants: A total of 148 eyes from 148 patients that underwent PPV with silicone oil tamponade for diabetic TRD (with DEX implant, n = 52; without DEX implant, n = 96).<br />Methods: Consecutive patients' records were reviewed for time between TRD diagnosis and surgery; lens status before surgery and after 6, 12, and 24 months; retina attachment rate after primary PPV; change in postoperative PVR severity; rate of re-detachment at 6, 12, and 24 months; use of IOP lowering treatment after 6, 12, and 24 months; surgery details; intra- and postoperative complications. Correlations between outcome measures, postoperative PVR severity, and re-detachment rates were analyzed.<br />Main Outcome Measures: Change in postoperative PVR severity and retinal re-detachment rates with and without the adjuvant use of DEX implant.<br />Results: Retinal re-detachment rates were significantly higher in the group of patients that did not receive DEX implant [11/96 (11.5%) vs. 0/52 (0%), p = 0.049; 11/84 (12.9%) vs. 4/52 (7.7%), p = 0.007; 14/71 (19.7%) vs. 5/52 (10%) p < 0.001 at 6, 12, and 24 months, respectively]. PVR severity correlated with retinal status at 12 and 24 months (p = 0.018 and p = 0.027, respectively). The difference in PVR severity between the two groups was statistically significant at 6, 12, and 24 months (p < 0.001).<br />Conclusions: DEX implant at the end of PPV in patients with diabetic TRD improves PVR severity and decreases re-detachment rates. This should be considered as an option in the customized treatment of TRD.
- Subjects :
- Adult
Aged
Combined Modality Therapy
Dexamethasone adverse effects
Diabetic Retinopathy complications
Drug Implants administration & dosage
Drug Implants adverse effects
Female
Humans
Intravitreal Injections
Male
Middle Aged
Postoperative Complications etiology
Postoperative Period
Retina drug effects
Retina physiopathology
Retrospective Studies
Silicone Oils administration & dosage
Silicone Oils adverse effects
Visual Acuity drug effects
Vitrectomy adverse effects
Vitreoretinopathy, Proliferative drug therapy
Vitreoretinopathy, Proliferative etiology
Vitreoretinopathy, Proliferative surgery
Dexamethasone administration & dosage
Diabetic Retinopathy drug therapy
Diabetic Retinopathy surgery
Retinal Detachment drug therapy
Retinal Detachment surgery
Vitrectomy methods
Subjects
Details
- Language :
- English
- ISSN :
- 1432-5233
- Volume :
- 56
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- Acta diabetologica
- Publication Type :
- Academic Journal
- Accession number :
- 31089929
- Full Text :
- https://doi.org/10.1007/s00592-019-01357-y