June 2020
Volume 61, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2020
Cataract surgery with combined versus deferred intravitreal dexamethasone implant for diabetic macular edema: long-term outcomes from a real world setting
Author Affiliations & Notes
  • Eleonora Corbelli
    IRCCS Ospedale San Raffaele, Milan, Italy
  • Giuseppe Querques
    IRCCS Ospedale San Raffaele, Milan, Italy
  • Francesco Fasce
    IRCCS Ospedale San Raffaele, Milan, Italy
  • Lorenzo Iuliano
    IRCCS Ospedale San Raffaele, Milan, Italy
  • Maria Vittoria Cicinelli
    IRCCS Ospedale San Raffaele, Milan, Italy
  • Rosangela Lattanzio
    IRCCS Ospedale San Raffaele, Milan, Italy
  • Mauro Campigotto
    NIDEK Technologies Srl, Padova, Italy
  • Patrih Saretta
    NIDEK Technologies Srl, Padova, Italy
  • Cesare Tanassi
    NIDEK Technologies Srl, Padova, Italy
  • Francesco Bandello
    IRCCS Ospedale San Raffaele, Milan, Italy
  • Footnotes
    Commercial Relationships   Eleonora Corbelli, None; Giuseppe Querques, None; Francesco Fasce, None; Lorenzo Iuliano, None; Maria Vittoria Cicinelli, None; Rosangela Lattanzio, None; Mauro Campigotto, None; Patrih Saretta, None; Cesare Tanassi, None; Francesco Bandello, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 3733. doi:
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      Eleonora Corbelli, Giuseppe Querques, Francesco Fasce, Lorenzo Iuliano, Maria Vittoria Cicinelli, Rosangela Lattanzio, Mauro Campigotto, Patrih Saretta, Cesare Tanassi, Francesco Bandello; Cataract surgery with combined versus deferred intravitreal dexamethasone implant for diabetic macular edema: long-term outcomes from a real world setting. Invest. Ophthalmol. Vis. Sci. 2020;61(7):3733.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To evaluate the long-term functional and anatomical outcomes of eyes undergoing cataract surgery combined with dexamethasone (DEX) implant in eyes with persistent diabetic macular edema (DME), and to compare with a matched sample undergoing the same procedure but with a 1-month deferred steroid injection.

Methods : Retrospective observation of all the institutional patients undergoing combined cataract surgery and intravitreal DEX from January 2010 to October 2017. Clinical data were collected by means of the institutional electronic medical chart NIDEK nLIFE. In the investigational combined group, best-corrected visual acuity (BCVA) and central retinal thickness (CRT) were extracted at baseline (combined surgery and DEX), 1, 4, 12 and 24 months after procedure. The deferred group was analyzed the day of surgery, the day of DEX injection (baseline), then according to the same time points of the investigational group.

Results : Forty eyes were analyzed, 20 in the combined and 20 in the deferred group. BCVA disclosed akin trends in both, increasing from similar starting values (p=0.9913) to comparable scores 1 month after DEX (p=0.4229). After 4 months BCVA similarly dropped down in both groups, with nonsignificant variations within each group. CRT was similar at the time of surgery (p=0.6134). DEX injection positively reduced CRT in both sample, with a superior beneficial effect in the combined group after 1 month (p=0.001003). At 4 months, CRT further elevated and remained overall stable, without differences between the two samples.
By 12 months 19 (95%) eyes received further injections: 1 (5%) fluocinolone, 3 (15%) received 1 DEX and 1 fluocinolone, 13 (65%) at least 1 DEX only, and 2 (10%) anti-VEGFs. Throughout the second year 6 additional eyes (from the 13 receiving DEX) switched to fluocinolone, reaching a total of 10 (50%). Similar results were observed in the deferred group.

Conclusions : DEX implant performed at the time of surgery achieved the same long-term functional and anatomical outcomes of 1-month deferred DEX implant in treating eyes with persistent DME that should undergo cataract extraction. Combined treatment might protect the diabetic eye by lessening the surgical inflammatory load, and additionally reduce the burden of repeated series of visits required for deferred procedures.

This is a 2020 ARVO Annual Meeting abstract.

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