Vitrectomy combined with intravitreal injection of Dexamethasone sustained-release agent for the treatment of idiopathic macular epiretinal membrane

AIM: To investigate the efficacy of vitrectomy combined with intravitreal injection of dexamethasone sustained-release agent for the treatment of idiopathic macular membrane(IMEM).METHODS: A retrospective analysis was conducted on 72 patients(72 eyes)diagnosed with IMEM at Xi'an People's Hospital from January 2019 to January 2023. They were divided into Group A and Group B according to different treatment method. Group A, consisting of 36 eyes, underwent vitrectomy, epiretinal membrane(ERM)removal surgery, and dexamethasone intraocular injection treatment; group B(36 eyes)only received vitrectomy and ERM removal surgery. Follow up for 12 mo, the best corrected visual acuity(BCVA), intraocular pressure, central macular thickness(CMT), and changes in macular retinal structure before and at 1, 3, 6, and 12 mo after surgery were compared.RESULTS: There were significant differences in BCVA between the two groups at 1, 3, and 6 mo postoperatively(all P<0.05), with group A showing a more significant improvement in visual acuity; there was no significant difference in BCVA between the two groups at 12 mo after surgery(P=0.056). There were significant differences in CMT between the two groups at 1, 3, and 6 mo postoperatively(all P<0.05), with a more significant decrease in CMT of the group A compared with the group B; there was no significant difference in CMT between the two groups at 12 mo after surgery(P=0.165). The comparison of intraocular pressure before and after surgery were all statistically significant(Ftime=2.763, Ptime<0.05; Fintergroup=26.800, Pintergroup<0.05; Finteraction=5.091, Pinteraction<0.05). Group A showed significant structural changes in the macula and retina after surgery.CONCLUSION: Vitreous surgery combined with single intravitreal injection of slow-release dexamethasone in patients with late stage IMEM can rapidly improve macular morphology and help restore visual function within 6 mo after surgery.