{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T09:03:10Z","timestamp":1785488590828,"version":"3.56.0"},"reference-count":65,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T00:00:00Z","timestamp":1785369600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background: Epiretinal membrane (ERM) is a fibrocellular preretinal proliferation composed of fibroblasts, glial cells, and hyalocytes overlying the internal limiting membrane. Pars plana vitrectomy (PPV) with membrane peeling is the standard surgical treatment, but postoperative cystoid macular edema (CME) can limit visual recovery. Inflammation plays a key role in CME pathogenesis, and corticosteroids may help reduce the inflammatory response associated with both ERM-related traction and surgical trauma. Therefore, sustained-release dexamethasone (DEX) intravitreal implants have been investigated as an adjunct to surgery. Methods: This SANRA-guided narrative review evaluated studies investigating DEX implantation during PPV for ERM surgery or as treatment for persistent postoperative CME. Eligible studies included human clinical studies reporting functional, anatomical, biomarker, or safety outcomes following DEX use in the ERM surgical setting. Results: DEX implantation appears to promote faster resolution of postoperative inflammation and CME, with consistent improvements in anatomical parameters such as central macular thickness. However, the impact on visual acuity remains variable, with some studies reporting earlier functional recovery and others showing no significant long-term benefit. Reported adverse events mainly include intraocular pressure elevation manageable with medical therapy and cataract progression. Available evidence suggests that intraoperative DEX implantation is associated with more consistent anatomical benefit than superior long-term functional improvement, while delayed DEX administration may benefit selected eyes with persistent postoperative cystoid macular edema. Conclusions: Current evidence suggests that DEX implantation may represent a potentially useful adjunctive strategy in selected patients undergoing ERM surgery, particularly in eyes at higher risk of postoperative inflammation or cystoid macular edema. While available studies suggest potential anatomical benefits, evidence regarding superior long-term functional outcomes remains inconsistent. Moreover, while current evidence suggests that DEX implantation may accelerate anatomical recovery and improve postoperative inflammatory control in selected patients, long-term functional superiority over PPV alone, including sustained BCVA improvement and patient-reported visual outcomes such as metamorphopsia, remains unproven. Larger prospective randomized studies are needed to better define optimal patient selection and treatment timing.<\/jats:p>","DOI":"10.3390\/jcm15155966","type":"journal-article","created":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T13:55:11Z","timestamp":1785419711000},"page":"5966","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Dexamethasone Implant in Epiretinal Membrane Surgery: A Clinically Oriented Narrative Review of Current Evidence, Biomarkers and Patient Selection"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1688-6646","authenticated-orcid":false,"given":"Clemente Maria","family":"Iodice","sequence":"first","affiliation":[{"name":"Multidisciplinary Department of Medical, Surgical and Dental Sciences, Eye Clinic, University of Campania Luigi Vanvitelli, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-7523-4581","authenticated-orcid":false,"given":"Michele","family":"Cillis","sequence":"additional","affiliation":[{"name":"Ophthalmology Unit, Department of Neuroscience, University of Padua, 35122 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8532-4578","authenticated-orcid":false,"given":"Danilo","family":"Iannetta","sequence":"additional","affiliation":[{"name":"Department of Sense Organs, Sapienza University of Rome, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rabia","family":"Bourkiza","sequence":"additional","affiliation":[{"name":"Ophthalmology Department, Central Middlesex Hospital, London Northwest University Healthcare NHS Trust, London HA1 3UJ, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1368-6729","authenticated-orcid":false,"given":"Michele","family":"Reibaldi","sequence":"additional","affiliation":[{"name":"Section of Ophthalmology, Department of Surgical Sciences, University of Turin, 10124 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8881-0926","authenticated-orcid":false,"given":"Paola","family":"Marolo","sequence":"additional","affiliation":[{"name":"Section of Ophthalmology, Department of Surgical Sciences, University of Turin, 10124 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrico","family":"Borrelli","sequence":"additional","affiliation":[{"name":"Section of Ophthalmology, Department of Surgical Sciences, University of Turin, 10124 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4712-6631","authenticated-orcid":false,"given":"Giulia","family":"Midena","sequence":"additional","affiliation":[{"name":"IRCCS\u2014Fondazione Bietti, 00184 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8399-7456","authenticated-orcid":false,"given":"Georgios D.","family":"Panos","sequence":"additional","affiliation":[{"name":"First Department of Ophthalmology, AHEPA University Hospital, School of Medicine, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece"},{"name":"Division of Ophthalmology and Visual Sciences, School of Medicine, University of Nottingham, Nottingham NG7 2RD, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariantonia","family":"Ferrara","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, 25121 Brescia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2681-4961","authenticated-orcid":false,"given":"Josef","family":"Guber","sequence":"additional","affiliation":[{"name":"Augenklinik Thurgau, 8500 Frauenfeld, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aman","family":"Chandra","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Southend University Hospital, Mid and South Essex NHS Foundation Trust, Southend-on-Sea SS0 0RY, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger","family":"Wong","sequence":"additional","affiliation":[{"name":"Ophthalmology Department, St Thomas\u2019 Hospital, London SE1 7EH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theo","family":"Empeslidis","sequence":"additional","affiliation":[{"name":"Stoneygate Eye Hospital, Leicester LE2 2PN, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Motta","sequence":"additional","affiliation":[{"name":"Ophthalmology Unit, Department of Neuroscience, University of Padua, 35122 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/S0161-6420(02)01443-4","article-title":"Five-year cumulative incidence and progression of epiretinal membranes: The Blue Mountains Eye Study","volume":"110","author":"Guzowski","year":"2003","journal-title":"Ophthalmology"},{"key":"ref_2","first-page":"403","article-title":"Surgical Treatment of Epiretinal Membrane","volume":"75","author":"Matoba","year":"2021","journal-title":"Acta Med. 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