One Intravitreal Dexamethasone Implant versus Multiple Intravitreal Injections of Triamcinolone Acetonide for Post-Surgical Macular Edema: Efficacy and Safety

Abstract

Abstract Purpose: The aim of the study is to compare the efficacy and safety of one or multiple intravitreal triamcinolone acetonide (ITA) injections to a single intravitreal dexamethasone implant (IDI) in the treatment of post-surgical cystoid macular edema (CME). Methods: A retrospective study was conducted on 99 consecutive eyes between January 2019 and January 2022. Sixty five of 99 eyes (65.7%) received ITA and 34 of 99 eyes (34.3%) received IDI. The anatomical and functional results were based on best corrected visual acuity (BCVA) and central retinal thickness (CRT) with a follow up period of 6 months. Also post-injection complications were studied, particularly increase in intraocular pressure (IOP) and cataract progression in phakic eyes. Results: BCVA improved in 84 of 99 eyes (85%), 53 of 65 eyes (82%) in the ITA group and 31 of 34 eyes (91%) in the IDI group, and the difference between both groups was not significant (p=0.058). CRT improved in 89 of 99 eyes (90%), 57 of 65 eyes in the ITA group (88%) and 32 of 34 eyes (94%) in the IDI group, and the difference between both groups was not significant (P=0.074). Fifteen of 65 eyes (23%) in the ITA group and 7 of 34 eyes (21%) in the IDI group had increased IOP. There was no significant difference between the two groups (P=0.627). Cataract progression occurred in 1 of 4 phakic eyes (25%) in the ITA group, while none occurred in the IDI group (P=0.214). Conclusion: At the final follow-up, no significant difference was observed between both the ITA and the IDI groups in terms of BCVA, CRT, and increase in IOP.