Abstract
Purpose :
The DRCR.net implicated cataract surgeries increased the risk of postoperative diabetes macular edema (DME) in 16 weeks and worsening of postoperative visual outcome. Whether concurrently anti-VEGF injection in cataract surgery in diabetic patients decrease the risk of DME has not been investigated.
Methods :
A retrospective observational study was conducted from 2016/01/01 to 2020/10/31. All patients were diagnosed with diabetic mellitus prior to the operation. DME was defined as central subfield thickness (CST) 300 µm or more. Epiretinal membrane or tractinal maculopathy were excluded. All the cataract surgeries were done by a single surgeon with phacoemulsification and posterior chamber intraocular ocular lens implantation in the capsular bag without any posterior capsular tear or any other intra- or post-operative complications. We concurrently perform cataract surgery and intravitreal injection of 2 mg aflibercept (0.05 mL) in 43 eyes. The control group only received cataract surgery without intravitreal injection in 65 eyes. We analyzed the post-operative visual acuity, CST changes and the incidence of post-operative DME. CST was measured by spectral domain optical coherence tomography (Optovue, Inc, Fremont, California) prior and three months after surgery.
Results :
108 eyes in 74 patients were included. 43 eyes received cataract surgery and intravitreal injection concurrently, in which 8 eyes were found pre-operation DME (group A) and 35 eyes not (group C). 65 eyes received cataract surgery only, and 11 of which were found pre-operation DME (group B) and 54 not (group D).
CST was decreased in patients with DME in group A but increased in group B (-3.3±47.3 µm versus 28.0±35.2 µm) (fig 1.). The visual acuity improved significantly in group A than group B (p<0.01) (fig 2.). There was no significantly different in CST changes, incidence of postoperative CME (8.5% and 9.2 % respectively) and visual acuity between Group C and D.
Conclusions :
This study showed that if diabetic patients were diagnosed as DME postoperatively, concurrently intravitreal injection of anti-VEGF in cataract surgery may be beneficial in decreasing postoperative CST and improving visual acuity. If there is no preoperative DME initially, the role of anti-VEGF may not be highlighted.
This is a 2021 ARVO Annual Meeting abstract.