Efficacy of Intravitreal Dexamethasone Implant in Vitrectomized vs. Non-Vitrectomized Eyes: A Systematic Review and Meta-Analysis.

IF 2.6 4区医学 Q2 OPHTHALMOLOGY

Ocular Immunology and Inflammation Pub Date : 2025-07-02 DOI:10.1080/09273948.2025.2519851

Chanyuan Cao, Li Yao, Xupeng Shu, Guoxiao Yu

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引用次数: 0

Abstract

Objective: We conducted this present meta-analysis to examine the difference in efficacy and safety of intravitreal dexamethasone implant (DEXI) in vitrectomized and non-vitrectomized eyes.

Methods: All types of comparative studies published on PubMed, CENTRAL, Scopus, and Embase databases till March 10, 2025 were included. We conducted a random-effects meta-analysis for change in central macular thickness (CMT), best corrected visual acuity (BCVA) (as logMar), and rise in intraocular pressure (IOP).

Results: Thirteen studies were included comparing 365 vitrectomized eyes with 778 non-vitrectomized eyes. Studies included mixed etiologies of macular edema. Meta-analysis showed that change in CMT was not significantly different between the two groups at 1 month (MD: -11.34 95% CI: -47.51, 24.82 I² = 2%), 3 months (MD: -0.43 95% CI: -33.36, 32.5 I² = 44%), 6 months (MD: -0.69 95% CI: -33.57, 34.95 I² = 18%) or 12 months ((MD: 37.46 95% CI: -4.86, 79.77 I² = 86%). The pooled analysis found no statistically significant difference between the two groups for change in BCVA at 1 month (MD: 0.04 95% CI: -0.01, 0.09 I² = 32%), 3 months (MD: 0.04 95% CI: -0.02, 0.09 I² = 0%) and 6 months (MD: 0.06 95% CI: 0.00, 0.11 I² = 0%). However, change in BCVA was significantly higher in the vitrectomized group at 12 months (MD: 0.17 95% CI: 0.13, 0.22 I² = 54%). The meta-analysis found no statistically significant difference in the risk of a rise in IOP between the two groups (OR: 1.26 95% CI: 0.81, 1.95 I² = 0%). Subgroup analysis based on etiology did not change the results.

Conclusions: DEXI may be equally efficacious and safe in vitrectomized and non-vitrectomized eyes.

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玻璃体切割眼与非玻璃体切割眼玻璃体内地塞米松植入的疗效：系统回顾和荟萃分析。

目的：我们进行了本荟萃分析，探讨玻璃体切除术和非玻璃体切除术后玻璃体内地塞米松植入（DEXI）的疗效和安全性的差异。方法：纳入截至2025年3月10日在PubMed、CENTRAL、Scopus和Embase数据库中发表的所有类型的比较研究。我们对中央黄斑厚度（CMT）、最佳矫正视力（BCVA）（as logMar）和眼压（IOP）升高的变化进行了随机效应荟萃分析。结果：纳入13项研究，比较365只玻璃体切除眼和778只未玻璃体切除眼。研究包括黄斑水肿的混合病因。meta分析显示，两组患者在1个月（MD: -11.34 95% CI: -47.51, 24.82 I2 = 2%）、3个月（MD: -0.43 95% CI: -33.36, 32.5 I2 = 44%）、6个月（MD: -0.69 95% CI: -33.57, 34.95 I2 = 18%）或12个月（MD: 37.46 95% CI: -4.86, 79.77 I2 = 86%）时的CMT变化无显著差异。合并分析发现，两组患者在1个月（MD: 0.04 95% CI: -0.01, 0.09 I2 = 32%）、3个月（MD: 0.04 95% CI: -0.02, 0.09 I2 = 0%）和6个月（MD: 0.06 95% CI: 0.00, 0.11 I2 = 0%）时BCVA变化无统计学差异。然而，12个月时玻璃体切割组BCVA的变化明显更高（MD: 0.17 95% CI: 0.13, 0.22 I2 = 54%）。meta分析发现两组间IOP升高的风险无统计学差异（OR: 1.26 95% CI: 0.81, 1.95 I2 = 0%）。基于病因的亚组分析没有改变结果。结论：DEXI在玻璃体切除和非玻璃体切除的眼睛中同样有效和安全。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Ocular Immunology and Inflammation 医学-眼科学

CiteScore

6.20

自引率

15.20%

发文量

285

审稿时长

6-12 weeks

期刊介绍： Ocular Immunology & Inflammation ranks 18 out of 59 in the Ophthalmology Category.Ocular Immunology and Inflammation is a peer-reviewed, scientific publication that welcomes the submission of original, previously unpublished manuscripts directed to ophthalmologists and vision scientists. Published bimonthly, the journal provides an international medium for basic and clinical research reports on the ocular inflammatory response and its control by the immune system. The journal publishes original research papers, case reports, reviews, letters to the editor, meeting abstracts, and invited editorials.