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Among the eight patients, the time of onset of macular edema after cataract surgery was 0.5, 1, 2, 1.5, 2, and 3 months after cataract surgery. The mean was 1.4 ± 0.5 months, and the follow-up period was 3–9 months. Seven of the eight patients received one injection, and one patient received two injections (macular edema recurred 3 months after the first injection). Basic patient information is shown in Table 1.
Table 1. Basic information of patients with Irvine-Gass syndrome treated with intravitreal injection of Ozurdex
Case Age (years) Sex Macular edema after
cataract surgery
occurrence time
(month)BCVA
before
injection
(LogMar)BCVA
after
iInjection
(LogMar)CMT
before
injection
(μm)CMT
after
injection
(μm)Injection
timeFollow-up
time
(month)1 76 Male 2.0 0.8 0.1 692 254 1 6 2 57 Male 2.0 1.0 0.1 843 255 1 3 3 87 Male 1.0 0.7 0.1 632 245 1 6 4 70 Male 1.5 1.2 0.3 922 267 1 3 5 76 Male 1.0 0.5 0.0 508 233 1 6 6 55 Male 1.5 0.7 0.1 708 220 1 3 7 55 Female 0.5 1.1 0.4 802 461 2 9 8 61 Female 2.0 0.5 0.1 517 289 1 6 Note. BCVA, best corrected visual acuity; CMT, central macular thickness. -
The mean visual acuity BCVA (logMAR) was 0.81 ± 0.26 before Ozurdex implantation, and 0.20 ± 0.12, 0.13 ± 0.09, and 0.15 ± 0.13 at 2 weeks, 1 month, and 3 months after implantation, respectively. The mean visual acuity improved at all three follow-up time points after implantation compared with pretreatment, and all differences were statistically significant (P < 0.001). The improvement in visual acuity at 2 weeks after implantation compared to that at 1 month after implantation was statistically significant (P = 0.02) (Table 2 and Figure 1A).
Table 2. Comparison of changes in BCVA (LogMAR) between patients before and after treatment (x ± s)
Time BCVA (LogMar) t-value P-value Before injection 0.81 ± 0.26 − − 2 weeks after injection 0.20 ± 0.12 9.2 < 0.001 1 month after injection 0.13 ± 0.09 9.3 < 0.001 3 months after injection 0.15 ± 0.13 10.6 < 0.001 Note. BCVA, best corrected visual acuity. -
The mean CMT was 703.00 ± 148.88 μm before Ozurdex implantation and decreased to 258.87 ± 37.40 μm, 236.25 ± 28.74 μm, and 278.00 ± 76.82 μm at 2 weeks, 1 month, and 3 months after implantation, respectively. The mean CMT decreased at all three follow-up time points after implantation compared with pretreatment, and the differences were statistically significant (P < 0.001). The difference in the reduction of CMT at 2 weeks after implantation compared with that at 1 month after implantation was statistically significant (P < 0.05) (Table 3, Figure 1B, and Figure 2A–C).
Table 3. Comparison of changes in CMT of patients before and after treatment (x ± s)
Time CMT (μm) t-value P-value Before injection 703.00 ± 148.88 − − 2 weeks after injection 258.87 ± 37.40 9.9 0.000 1 month after injection 236.25 ± 28.74 9.8 < 0.001 3 months after injection 278.00 ± 76.82 8.1 < 0.001 Note. CMT, central macular thickness. -
The patient’s mean IOP before implantation was 12.62 ± 2.87 mmHg. The IOPs at 1 week, 1 month, and 3 months after implantation were 12.75 ± 2.12 mmHg, 12.62 ± 2.72 mmHg, and 12.12 ± 2.23 mmHg, respectively. The IOPs of all patients were within the normal range at all time points after implantation, and the differences with the preoperative IOPs were not statistically significant (P > 0.05).
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Only two of the eight patients had a small amount of subconjunctival hemorrhage at the injection site, which resolved spontaneously within 1 week after the surgery. No ocular complications, such as artificial lens dislocation, vitreous hemorrhage, retinal detachment, endophthalmitis, or systemic adverse events, were observed.
doi: 10.3967/bes2023.084
Observation of the Curative Effect of the Dexamethasone Vitreous Cavity Implant for the Treatment of Irvine-Gass Syndrome
-
Abstract:
Objective To investigate the clinical efficacy of dexamethasone vitreous cavity implants (Ozurdex) for the treatment of macular edema (Irvine-Gass Syndrome) after cataract surgery. Method Eight patients (eight eyes) with Irvine-Gass syndrome were enrolled for vitreous injections with Ozurdex. The patients included six men (six eyes) and two women (two eyes) with a mean age of 67.12 ± 11.92 years. Changes in the patients best-corrected visual acuity (BCVA), central macular thickness (CMT), and intraocular pressure were compared before and after treatment. Result The mean visual acuity BCVA of the patients was 0.81 ± 0.26 before implantation, which improved to 0.20 ± 0.12, 0.13 ± 0.09, and 0.15 ± 0.13 at 2 weeks, 1 month, and 3 months after implantation, respectively (P < 0.001). The patient’s mean CMT before implantation was 703.00 ± 148.88 μm, and it reduced to 258.87 ± 37.40 μm, 236.25 ± 28.74 μm, and 278.00 ± 76.82 μm at 2 weeks, 1 month, and 3 months after implantation, respectively (P < 0.001). Conclusion The dexamethasone vitreous cavity implant (Ozurdex) is a safe and effective treatment, which can effectively improve patient’s visual acuity and reduce macular edema associated with cataract surgery. -
Key words:
- Irvine-Gass Syndrome /
- Macular edema /
- Dexamethasone /
- Vitreous injection
The authors declare no competing interests.
注释:1) AUTHOR CONTRIBUTIONS: 2) CONFLICTS OF INTEREST: -
Table 1. Basic information of patients with Irvine-Gass syndrome treated with intravitreal injection of Ozurdex
Case Age (years) Sex Macular edema after
cataract surgery
occurrence time
(month)BCVA
before
injection
(LogMar)BCVA
after
iInjection
(LogMar)CMT
before
injection
(μm)CMT
after
injection
(μm)Injection
timeFollow-up
time
(month)1 76 Male 2.0 0.8 0.1 692 254 1 6 2 57 Male 2.0 1.0 0.1 843 255 1 3 3 87 Male 1.0 0.7 0.1 632 245 1 6 4 70 Male 1.5 1.2 0.3 922 267 1 3 5 76 Male 1.0 0.5 0.0 508 233 1 6 6 55 Male 1.5 0.7 0.1 708 220 1 3 7 55 Female 0.5 1.1 0.4 802 461 2 9 8 61 Female 2.0 0.5 0.1 517 289 1 6 Note. BCVA, best corrected visual acuity; CMT, central macular thickness. Table 2. Comparison of changes in BCVA (LogMAR) between patients before and after treatment (x ± s)
Time BCVA (LogMar) t-value P-value Before injection 0.81 ± 0.26 − − 2 weeks after injection 0.20 ± 0.12 9.2 < 0.001 1 month after injection 0.13 ± 0.09 9.3 < 0.001 3 months after injection 0.15 ± 0.13 10.6 < 0.001 Note. BCVA, best corrected visual acuity. Table 3. Comparison of changes in CMT of patients before and after treatment (x ± s)
Time CMT (μm) t-value P-value Before injection 703.00 ± 148.88 − − 2 weeks after injection 258.87 ± 37.40 9.9 0.000 1 month after injection 236.25 ± 28.74 9.8 < 0.001 3 months after injection 278.00 ± 76.82 8.1 < 0.001 Note. CMT, central macular thickness. -
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