Cataract surgery with combined versus deferred intravitreal dexamethasone implant for diabetic macular edema: long-term outcomes from a real-world setting

Corbelli, Eleonora; Fasce, Francesco; Iuliano, Lorenzo; Sacconi, Riccardo; Lattanzio, Rosangela; Bandello, Francesco; Querques, Giuseppe

doi:10.1007/s00592-020-01509-5

Cited by 7 publications

(11 citation statements)

References 25 publications

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“…In fact, if we compare the mean CRT reduction in the combined group (mean CRT reduction −179.4 ± 92.36 µm) versus the deferred group (-202.4 ± 32.4 µm ), we do not find any difference between them (mean difference −23.0 µm, 95% CI: −67.3 to 21.3 µm, p = 0.3000) (Data calculated according to Corbelli et al). 36 Moreover, comparing the results at month-24, the mean CRT reduction was significantly greater in the deferred group (-199.3 ± 27.1 µm) than in the combined one (-119.3 ± 73.2 µm) (mean difference −80.0 µm; 95% CI: −117.5 to −42.6 µm, p = 0.0001. Data calculated according to Corbelli et al), although it should be note that perprotocol many eyes received additional treatments (i.e.…”

Section: Discussionmentioning

confidence: 88%

“…Additionally, Corbelli et al, 36 in a retrospective study, compared the functional and anatomic outcomes of combined versus 1-month deferred DexI in DME eyes who underwent cataract surgery over a period of 24 months. The results of this study found no differences in BCVA at all the different time-points measured between combined and deferred DexI.…”

Section: Discussionmentioning

confidence: 99%

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Intraoperative dexamethasone intravitreal implant in diabetic macular edema patients undergoing phacoemulsification: The CataDex study

Vadalà

Trapani

Amato

et al. 2021

European Journal of Ophthalmology

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Purpose To assess the impact of preoperative intravitreal dexamethasone implant (DexI) on functional and anatomic outcomes in patients with diabetic macular edema (DME) who underwent phacoemulsification cataract surgery. Methods Prospective and non-comparative study conducted on consecutive DME patients undergoing cataract surgery. DexI was administered 15 days before surgery and in a pro re nata regime after surgery. Main outcome measures were mean change in central retinal thickness (CRT), central subfield thickness (CST), total macular volume (TMV), and central subfield volume (CSV) from baseline to month-12. Secondary outcome was mean change in best corrected visual acuity (BCVA). Results Forty eyes were included in the study. CRT significantly decreased from 410.4 ± 64.8 µm at baseline to 303.2 ± 24.3 µm at month-12, p < 0.0001. Similarly, CST was significantly reduced from 436.4 ± 120.4 µm at baseline to 322.9 ± 54.2 µm at month-12, p < 0.0001. Total macular volume and CSV were significantly reduced from 9.95 ± 1.68 mm3 and 0.38 ± 0.11 mm3 at baseline to 8.49 ± 0.83 mm3 and 0.31 ± 0.05 mm3 at month-12, respectively ( p < 0.0001 each, respectively). BCVA significantly improved from 0.26 ± 0.17 Snellen equivalent at baseline to 0.65 ± 0.19 at month-12, p < 0.0001. Mean DexI administered during the study were 2.0 ± 0.3. Neither DME subtype nor previous treatment status had any effect on functional or anatomic outcomes. Regarding safety, one (2.5%) eye developed ocular hypertension, which was successfully controlled with topical hypotensive treatment. Conclusions DexI was and effective and safe strategy for managing DME in diabetic patients undergoing uneventful cataract surgery.

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Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Intraoperative dexamethasone intravitreal implant in diabetic macular edema patients undergoing phacoemulsification: The CataDex study

Vadalà

Trapani

Amato

et al. 2021

European Journal of Ophthalmology

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“…Ozurdex, combined with phacoemulsification in patients with cataract and DME, showed beneficial functional and anatomical effects for at least 3 months after surgery [141,142]. Additionally, intraoperative Dex implants performed at the time of surgery achieved the same long-term outcomes compared to a 1-month injection deferral in treating eyes with pre-existing DME [140].…”

Section: Evidence Of the Efficacy Of Dex In Anterior Segment Surgerymentioning

confidence: 89%

“…Diabetic patients have an increased and independent risk of developing post-cataract ME, even after uncomplicated surgeries [140]. Ozurdex, combined with phacoemulsification in patients with cataract and DME, showed beneficial functional and anatomical effects for at least 3 months after surgery [141,142].…”

Section: Evidence Of the Efficacy Of Dex In Anterior Segment Surgerymentioning

confidence: 99%

Intravitreal Dexamethasone Implant as a Sustained Release Drug Delivery Device for the Treatment of Ocular Diseases: A Comprehensive Review of the Literature

et al. 2020

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Drug delivery into the vitreous chamber remains a great challenge in the pharmaceutical industry due to the complex anatomy and physiology of the eye. Intravitreal injection is the mainstream route of drug administration to the posterior segment of the eye. The purpose of this review is to assess the current literature about the widening use of the intravitreal 0.7 mg dexamethasone (Dex) implant, and to provide a comprehensive collection of all the ocular disorders that benefit from Dex administration. Although anti-vascular endothelial growth-factors (VEGFs) have been largely indicated as a first-choice level, the Dex implant represents an important treatment option, especially in selected cases, such as vitrectomized eyes or patients in whom anti-VEGF failed or are contraindicated. In this article, the safety profile as well as the list of the possible complications related to intravitreal Dex injection are also discussed.

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“…Delivering IDI 1 month prior or after cataract surgery showed comparable outcomes than concomitant with cataract surgery. 52 , 53 …”

Section: Discussionmentioning

confidence: 99%

Prophylactic interventions for preventing macular edema after cataract surgery in patients with diabetes: A Bayesian network meta-analysis of randomized controlled trials

Zhang¹,

Dong²,

Yang

et al. 2022

eClinicalMedicine

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Cataract surgery with combined versus deferred intravitreal dexamethasone implant for diabetic macular edema: long-term outcomes from a real-world setting

Cited by 7 publications

References 25 publications

Intraoperative dexamethasone intravitreal implant in diabetic macular edema patients undergoing phacoemulsification: The CataDex study

Intraoperative dexamethasone intravitreal implant in diabetic macular edema patients undergoing phacoemulsification: The CataDex study

Intravitreal Dexamethasone Implant as a Sustained Release Drug Delivery Device for the Treatment of Ocular Diseases: A Comprehensive Review of the Literature

Prophylactic interventions for preventing macular edema after cataract surgery in patients with diabetes: A Bayesian network meta-analysis of randomized controlled trials

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