Dexamethasone Intravitreal Implant at the Time of Cataract Surgery in Eyes with Diabetic Macular Edema

Abstract

Intraoperative DEX-I prevents DME worsening after phacoemulsification. Its positive effects last for at least 3 months.

Combined Phacoemulsification and Intravitreal Dexamethasone Implant (Ozurdex®) in Diabetic Patients with Coexisting Cataract and Diabetic Macular Edema

“…In our study, mean preoperative CRT (486 ± 152.4 μ m) was higher than that reported in previous papers (335.9 ± 90.6 μ m [ 14 ], 451 ± NR μ m [ 15 ], and 393 ± 166.5 μ m [ 16 ]) with a wide range of value (270–789 μ m) suggesting the heterogeneity of DME feature as a target for steroid therapy.…”

“…We considered performing safer implant at the end of cataract surgery when potential intraoperative complications were overcome and a better visualization of implant in the vitreous was possible. A prospective study published by Panozzo et al [ 15 ] suggested that intravitreal dexamethasone implant performed at the end of phacoemulsification and IOL implantation was safe and effective in naïve and refractory DME. Same results were reported in a small case series which included 12 patients with macular edema secondary to diabetic retinopathy and 12 patients with macular edema secondary to retinal vein occlusion [ 16 ].…”

“…Agarwal et al [ 14 ] reported a mean visual gain of 18 letters at 12 weeks. Panozzo et al [ 15 ] reported a stable mean visual improvement of 18 letters at month 2 after treatment. In this study, according to this cut-off value, the mean or median visual change (0.30 ± 0.28 logMAR; 0.30 logMAR) indicated a clinically significant improvement at 60 days (2 months).…”

“…In a prospective controlled, randomized interventional pilot trial, the intravitreal dexamethasone implant at the beginning of phacoemulsification significantly reduced central macular thickness and increased visual acuity after a 24-week follow-up [ 14 ]. But only two papers analyzed the safety and efficacy of Ozurdex implant at the end of cataract surgery in patients with diabetic macular edema [ 15 , 16 ].…”

Short-Term Results of Intravitreal Triamcinolone Acetonide Combined with Cataract Surgery for Diabetic Macular Edema in Japan: In the Era of Anti-Vascular Endothelial Growth Factor Therapy

“…These agents have often been used for patients resistant to anti-VEGF agents [26]. The efficacy of the combined use of sustained-release agents with cataract surgery or vitrectomy has also been reported [27-29]. Like TA, they are also known to cause an elevation of the IOP and cataract progression.…”