Comparison of Perioperative Ranibizumab Injections for Diabetic Macular Edema in Patients Undergoing Cataract Surgery

Abstract

Purpose. To compare the efficacy of perioperative ranibizumab injections on diabetic macular edema (DME) in patients undergoing cataract surgery. Methods. This study included 59 eyes of 59 patients. All patients had advanced cataract with DME and underwent an uneventful phacoemulsification surgery. There were 3 subgroups. The first group received intravitreal ranibizumab injection 2 weeks preoperatively, the second group received intraoperatively, and the third group received 2 weeks postoperatively. Follow-up examinations were performed at 1 week as well as at 1 and 3 months. Results. Baseline visual acuity showed a significant increase in all groups at 1 month. In group 1, compared to baseline value, foveal thickness (FT) increased significantly at 1 month and showed a significant decrease up to month 3. In group 2, FT increased at month 1 and this continued up to month 3. In group 3, FT increased at month 1 and was almost stable up to month 3. There were not any significant differences for visual acuity and FT between the groups. Conclusions. Although intrapostoperative ranibizumab injection for DME seems to be more effective than preoperative injections in patients undergoing cataract surgery, the treatment still needs to be continued following surgery.

Clinical Observation of Phacoemulsification Combined with Intravitreal Injection of Conbercept in Cataract Patients with Diabetic Macular Edema

“…The postoperative CMT in the observation group decreased significantly, while that in the control group increased slightly. These results were close to those of Yumusak et al [ 11 ]. Denniston et al found that the concentration of VEGF in the aqueous humor of diabetic patients increased from 68 pg/ml at baseline to 723 pg/ml one day after surgery, yielding a tenfold increase [ 9 ].…”

Cataract surgery in diabetes mellitus: A systematic review

“…It has been shown that intraoperative intravitreal ranibizumab with cataract surgery is more effective than preoperative or postoperative injection for DME although an ongoing treatment is needed in these patients. [ 50 ] Steroids, on the other hand, have shown to be effective for persistent or refractory DME. [ 50 ] Dexamethasone has potentially less risk of intraocular pressure (IOP) elevation and cataract formation compared to fluocinolone acetonide and triamcinolone acetate.…”

“…[ 50 ] Steroids, on the other hand, have shown to be effective for persistent or refractory DME. [ 50 ] Dexamethasone has potentially less risk of intraocular pressure (IOP) elevation and cataract formation compared to fluocinolone acetonide and triamcinolone acetate. [ 51 ] Furthermore, the intravitreal dexamethasone implants and fluocinolone implants require less frequent injections.…”

Cataract in diabetes mellitus

“…Because preexisting DME can increase the risk of ME progression by 20%–50%, intravitreal antiVEGF agents are recommended perioperatively[ 45 , 46 ]. Steroids, on the other hand, have been shown to be effective for persistent or refractory DME[ 47 ]. Dexamethasone implants and fluocinolone implants resulted in significant improvement in clinically significant ME and visual outcomes[ 48 , 49 ].…”