Intraoperative dexamethasone implant during PPV with silicone oil for diabetic retinal detachment may improve postoperative visual and anatomical outcomes, and warrants further evaluation in prospective randomized studies.
Key Findings
Results
Eyes receiving a simultaneous intraoperative dexamethasone implant had better 6-month visual acuity than eyes undergoing standard PPV with silicone oil.
BCVA at 6 months was 0.62 ± 0.14 logMAR in Group A (standard PPV with silicone oil) versus 0.48 ± 0.12 logMAR in Group B (PPV plus dexamethasone implant) (P < 0.01).
Retrospective comparative case series of 60 eyes of 60 patients, 30 per group, at a tertiary eye care center.
All patients were followed for at least 6 months; silicone oil removal was performed at 2-3 months.
Results
Central macular thickness at 6 months was lower in the dexamethasone implant group.
Mean CMT was 314 ± 35 μm in Group A versus 272 ± 28 μm in Group B (P < 0.05).
CMT was a main outcome measure along with BCVA.
Results
Postoperative macular edema was less frequent in eyes that received the dexamethasone implant.
Macular edema occurred in 30% of eyes in Group A versus 10% in Group B.
No P value for this comparison is given in the abstract.
Results
Rescue dexamethasone therapy was needed only in the standard PPV group.
Rescue dexamethasone was required in 16.7% of Group A and none (0%) of Group B.
Results
Epiretinal membrane formation was numerically lower with the implant, but the difference was not statistically significant.
ERM was observed in 23.3% of Group A versus 6.7% of Group B (P = 0.07).
Results
Secondary internal limiting membrane peeling was required only in the standard PPV group.
Secondary ILM peeling was needed in 10% of Group A versus 0% of Group B.
Results
Anatomical retinal reattachment rates at 6 months were comparable between groups.
Reattachment was 93.3% in Group A versus 96.7% in Group B.
Eyes had diabetic tractional or combined tractional-rhegmatogenous retinal detachment.
What This Means
This study looked back at the records of 60 people with diabetic retinal detachment who had vitrectomy surgery with silicone oil placed in the eye. Thirty had standard surgery, and thirty also received a dexamethasone (steroid) implant during the operation. Silicone oil was removed at 2-3 months, and everyone was followed for at least 6 months.
At 6 months, eyes that received the steroid implant had better vision and thinner central retina (a sign of less swelling). Macular swelling occurred in 30% of eyes without the implant versus 10% with it. Scar-like membrane formation was 23.3% versus 6.7%, though that difference was not statistically significant. Only the standard-surgery group needed extra steroid treatment (16.7%) or a second membrane-peeling procedure (10%). Rates of successful retinal reattachment were similar (93.3% vs 96.7%).
This research suggests that adding a steroid implant during surgery may help visual and anatomical recovery in this setting. However, the study was retrospective, small, and from a single center, so the groups may have differed in ways not accounted for. The authors say prospective randomized studies are needed to confirm these findings.
Ambiya V, Modi S, Kapoor G, Sharma V, Bhatta S, Rahul. (2026). Dexamethasone implant in vitreoretinal surgery for diabetic retinal detachment: A retrospective comparative study.. Indian journal of ophthalmology. https://doi.org/10.4103/IJO.IJO_892_26