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Rodrigo Jorge, Paulo I. Rauen, Jefferson A. Ribeiro, Ingrid U. Scott, Andre Messias; Intravitreal Injection of Ranibizumab During Cataract Surgery in Patients with Diabetic Macular Edema. Invest. Ophthalmol. Vis. Sci. 2011;52(14):576.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate macular thickness and visual acuity changes after one intravitreal injection of 0.5mg ranibizumab (IVR) during phacoemulsification cataract surgery in eyes with diffuse diabetic macular edema (DME) non-responsive to modified ETDRS laser therapy.
Eleven eyes of 11 patients with refractory diffuse DME scheduled to undergo phacoemulsification cataract surgery received IVR during cataract surgery. Comprehensive ophthalmic evaluation was performed preoperatively and at 1, 4, 8±1 and 12±2 weeks postoperatively. Main outcome measures included central subfield thickness (CSFT) measured with time-domain optical coherence tomography (OCT) and best-corrected ETDRS visual acuity.
Eleven patients completed the 12-week study visit. Mean CSFT (± SEM) was 399.82 ± 29.50 µm at baseline and did not change significantly at any postoperative study visit (P>0.05). Mean BCVA (± SEM) was 0.95 ± 0.13 LogMAR (20/200) at baseline and was significantly improved at weeks 1 (0.38 ± 0.13), 4 (0.38 ± 0.11), 8 (0.35 ± 0.08) and 12 (0.46 ± 0.12) after treatment (P<0.05). No significant change in intraocular pressure was observed during follow-up (p<0.05).
In this small case series of patients with DME refractory to laser therapy, IVR during cataract surgery was not associated with significant reduction in CSFT postoperatively. Significant improvement in BCVA was observed after treatment, likely due to cataract removal. Further investigation of a larger number of patients with longer follow-up is necessary to confirm these preliminary findings.
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