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

Zhang, Ruiheng; Dong, Li; Yang, Qiong; Liu, Yueming; Li, Heyan; Zhou, Wen-Da; Wu, Haotian; Li, Yifan; Li, Yitong; Yu, Chuyao; Wei, Wen Bin

doi:10.1016/j.eclinm.2022.101463

Cited by 6 publications

(4 citation statements)

References 52 publications

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“…Several small studies showed that diabetic patients receiving anti-VEGF injections at the end of surgery had less postoperative macular thickening than those who did not (12,18). In a recently published meta-analysis, Zhang et al showed that intraoperative injection of anti-VEGF was associated with better BCVA outcomes at 1 month and 3 months postoperatively, but not at 6 months after surgery (34). The ESCRS PREMED Study Report 2 showed that intravitreal triamcinolone, but not bevacizumab, had a significant effect in preventing macular thickness (35).…”

Section: Discussionmentioning

confidence: 99%

Postoperative complications of combined phacoemulsification and pars plana vitrectomy in diabetic retinopathy patients

Gershoni

Barayev²,

Jbara³

et al. 2022

Front. Med.

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PurposeTo compare intra- and postoperative complications in combined phacoemulsification and pars plana vitrectomy surgeries performed in patients with non-proliferative diabetic retinopathy (NPDR) vs. proliferative diabetic retinopathy (PDR).MethodsRetrospective, case series of patients with diabetic retinopathy who underwent combined phacovitrectomy surgery between 2008 and 2017. We compared intraoperative complications including posterior capsular rupture and retinal tear, and postoperative complications including corneal edema, macular edema (ME), epiretinal membrane (ERM), neovascular glaucoma and persistent inflammation.ResultsA total of 104 eyes of 104 patients were included in this study. Twenty-four eyes (23.1%) were categorized as NPDR and 80 eyes (76.9%) as PDR. The most common indications for surgery in the NPDR group were ERM (67%) and rhegmatogenous retinal detachment (12.5%), while in the PDR group, indications were vitreous hemorrhage (56%) and tractional retinal detachment (19%). The most common intraoperative complication was retinal tear (8% in NPDR and 19% in PDR, p = 0.195) and postoperative complication was ME (29% in NPDR and 26% in PDR, p = 0.778). There were no statistically significant differences in intra- and postoperative complication rates between the NPDR and PDR groups, even after adjusting for confounders; patient age at surgery and indication for surgery.ConclusionAfter combined phacovitrectomy in NPDR and PDR patients, new-onset ME was found in about a quarter of eyes in both groups. Intraoperative anti-VEGF or steroid administration, and intense postoperative anti-inflammatory medication and follow-up should be regarded after phacovitrectomy regardless of the DR level.

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Section: Discussionmentioning

confidence: 99%

Postoperative complications of combined phacoemulsification and pars plana vitrectomy in diabetic retinopathy patients

Gershoni

Barayev²,

Jbara³

et al. 2022

Front. Med.

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“…Next, the AI model was used in the processed data as a data source. The Convolutional Neural Network (CNN) algorithm was used to construct the machine learning model, and the desired final label output was two multi-classes [26,27,28,29,30,31]. Figure 3 shows the CNN algorithm.…”

Section: Figure 2 Flowchart Of Cnnmentioning

confidence: 99%

Early detection of diabetes potential using cataract image processing approach

Khairudin,

Mahaputra,

Wiharto

et al. 2023

Sinergi

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Diabetes is a disease characterized by a high level of sugar in the blood. The disease occurs because of a disruption in the metabolic system when insulin is not produced effectively and functions properly. High blood sugar levels, for an extended period of time, can harm a few organ systems, including the heart and kidneys. Moreover, it may cause blindness or death if it is not carefully monitored. Because diabetes symptoms are rarely seen, one of the factors that may cause diabetes is self-awareness. Thus, with Artificial Intelligence, this problem can be solved. Artificial intelligence studies how machines can function like humans. This study implemented a Convolutional Neural Network algorithm with (1) input layer, (2) feature learning layer, (3) classification layer, and (4) output layer as the architecture for AI. The accuracy of the developed AI model was measured from its precision, recall, and f1-score. The results show that the model obtained 90% precision, recall, and f1-score for real-world cases found in two hospitals located in Solo and Yogyakarta, Indonesia. According to the results of the tests, 9 out of 10 patients were correctly predicted as having a high risk of diabetes based on their eye images.

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“…NSAIDs are recommended after the cataract surgery when there are two or more risk factors for PCME, and diabetes is one of them [88,89]. However, there is a lack of studies of PCME prevention with pretreatment strategy for diabetics.…”

Section: Andandmentioning

confidence: 99%

Management of inflammation after the cataract surgery

Grzybowski

Sidaraitė

Žemaitienė

2022

Current Opinion in Ophthalmology

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Purpose of reviewTo review most recent studies and clinical trials regarding pathogenesis, treatment, and prevention of inflammation after the cataract surgery.Recent findings FLACS gave opportunity to evaluate inflammatory cytokines in the aqueous humour right after the laser procedure, which led to acknowledging the inflammation pathogenesis during the phacoemulsification. Although there is still a lack of evidence, which would prove the long-term benefit of NSAIDs, they are indicated and effective when risk factors for PCME are present. PREMED studies showed that combination of NSAID and steroids after the surgery for healthy subjects is cost-effective. The triamcinolone injection together with topical steroids and NSAIDs for diabetic patients after the cataract surgery was the most costeffective in preventing PCME according to the PREMED. Dropless cataract surgery is another emerging topic: dexamethasone implants and suspensions look promising as we await more clinical trials with drugloaded IOLs.

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

Cited by 6 publications

References 52 publications

Postoperative complications of combined phacoemulsification and pars plana vitrectomy in diabetic retinopathy patients

Postoperative complications of combined phacoemulsification and pars plana vitrectomy in diabetic retinopathy patients

Early detection of diabetes potential using cataract image processing approach

Management of inflammation after the cataract surgery

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