DIABETIC MACULAR EDEMA AND CATARACT SURGERY: Phacoemulsification Combined With Dexamethasone Intravitreal Implant Compared With Standard Phacoemulsification
Claudio Furino, Francesco Boscia, Alfredo Niro, Maria D'Addario, Maria O Grassi, Valeria Saglimbene, Michele Reibaldi, Giovanni Alessio, Claudio Furino, Francesco Boscia, Alfredo Niro, Maria D'Addario, Maria O Grassi, Valeria Saglimbene, Michele Reibaldi, Giovanni Alessio
Abstract
Purpose: To compare functional and anatomical results of combined phacoemulsification and dexamethasone intravitreal implant (Ozurdex; DEX-I) with standard phacoemulsification in diabetic patients with cataract.
Methods: Retrospective, comparative, cohort study. Patients with nonproliferative diabetic retinopathy, macular edema, and cataract, treated routinely at the Eye Clinic, Azienda Ospedaliero Universitaria Policlinico, Bari, Italy with phacoemulsification associated with DEX-I (n = 23; Phaco-Dex) or standard phacoemulsification (n = 23; Phaco-alone). Best-correct visual acuity, central subfield thickness, and intraocular pressure were assessed at baseline and monthly for 3 months after surgery, and t-test was used to assess change from baseline. A multilevel regression model with an unstructured correlation-type matrix to account for repeated data measures was used for statistical analysis in and between groups.
Results: With Phaco-Dex, best-correct visual acuity increased significantly from the first month (P = 0.0005 vs. baseline) and remained stable at the following visits; central subfield thickness decreased significantly from Month 2 (P = 0.049 and P = 0.04 vs. baseline, respectively); at each timepoint, central subfield thickness was significantly lower in the Phaco-Dex group versus Phaco-alone. Intraocular pressure increased significantly during follow-up (P = 0.001 at Month 3 vs. baseline) but remained within the normal range. In the Phaco-alone group, best-correct visual acuity, and intraocular pressure did not show any significant changes after surgery, whereas central subfield thickness increased from Month 2 (P = 0.05 vs. baseline).
Conclusion: In diabetic patients with macular edema and visually significant cataract, combined treatment with phacoemulsification and DEX-I seemed to be effective, safe, and superior to standard phacoemulsification considering both functional and tomographic parameters.
Conflict of interest statement
None of the authors has any financial/conflicting interests to disclose.
Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the Opthalmic Communications Society, Inc.
Figures
![Fig. 1.](https://www.ncbi.nlm.nih.gov/pmc/articles/instance/8078110/bin/retina-41-1102-g001.jpg)
![Fig. 2.](https://www.ncbi.nlm.nih.gov/pmc/articles/instance/8078110/bin/retina-41-1102-g002.jpg)
![Fig. 3.](https://www.ncbi.nlm.nih.gov/pmc/articles/instance/8078110/bin/retina-41-1102-g003.jpg)
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Source: PubMed