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

Ocul Immunol Inflamm. 2025 Jul 2:1-9. doi: 10.1080/09273948.2025.2519851. Online ahead of print.

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.

PMID:40601878 | DOI:10.1080/09273948.2025.2519851

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