Abstract
Purpose :
To compare the visual outcome in terms of best corrected visual acuity (BCVA) and progression of diabetic maculopathy in terms of central macular thickness (CMT) in patients with diabetic macular edema (DME) and cataract undergoing phacoemulsification with intravitreal bevacizumab (IVB)or intravitreal triamcinolone acetonide(IVTA).
Methods :
The study is a retrospective hospital based longitudinal observational comparative study.
Results :
Sixty patients (63 eyes) underwent phacoemulsification with IVB injection while 70 patients (75 eyes) had phacoemulsification with IVTA.The mean pre-operative visual acuity in log Mar ±SD in the IVB group was 0.94±0.58 and in IVTA group it was 0.92±0.54, both were comparable(p=0.83). The BCVA improved to 0.52±0.47 in the bevacizumab group at 3 weeks follow up and 0.51±0.45 at 3 months follow up, both were statistically significant compared to the preoperative visual acuity (p=0.00).In the IVTA group the mean pre-operative BCVA in logmar±SD was 0.92±0.54 and the mean BCVA improved to 0.40±0.26 at 3 weeks follow up and 0.48±0.32 at 3 months follow up,both were statistically significant compared to preoperative level(p=0.00).The mean pre-operative central macular thickness in the IVB group was 396.41±170.20, at 3 weeks follow up it was 437.27±217.48 and at 3 months follow up it was 457±206.94.The mean pre-operative central macular thickness in the IVTA group was 467.79±179.92 ,at 3 weeks follow up it was 382.58±192.30. At 3 months follow up the central macular thickness in the IVTA group was 445.51±222.10.Even though the mean CMT reduced from preoperative level in the IVTA group, the difference was statistically significant only at 3 weeks follow up (p=0.015), at 3 months the decrease in CMT was not statistically significant(p=0.293).
Conclusions :
Both IVTA and intravitreal bevacizumab when given along with phacoemulsification in patients with DME improved the vision significantly at 3 weeks and 3 months follow up.The improvement in BCVA was more with IVTA compared to IVB but it was statistically significant only at 3 weeks follow up.The CMT worsened in IVB group and improved in IVTA group, but the improvement in CMT was statistically significant only at 3 weeks follow up.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.