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Impact of cataract surgery on central macular thickness in patients with diabetic macular edema

Poster Details

First Author: N.Khater EGYPT

Co Author(s):    N. Abou Hussien   A. A Abdel-Kader           

Abstract Details


To compare the changes in central macular thickness (CMT) following cataract surgery and intravitreal ranibizumab in patients with diabetic macular edema (DME), to the changes in macular thickness in fellow non-operated eye.


AL Oyoun Al Dawli Hospital, Dokki, Giza - Egypt


The study included 40 eyes of 40 patients with DME (CMT > 300 µm) and cataract in a controlled prospective randomized clinical trial. All patients underwent phacoemulsification, intraocular lens implantation (IOL) and intravitreal injection of 0.5 mg ranibizumab under topical anesthesia. The fellow non-operated eye was used as a control over a period of 3 months. Best corrected visual acuity (BCVA) and central macular thickness (CMT);using spectral domain OCT, were recorded at baseline and at 2 weeks, 1, 2 and 3 months respectively for both operated and control eyes.


All patients under study completed the 3 months follow up period. All 40 operated eyes (100%) showed an initial significant improvement in BCVA ≥ 3 lines during the first month (mean BCVA 20/40). 16 eyes (40%) showed a subsequent decline in BCVA after 1 month (mean BCVA 20/70). All 40 control eyes had stable vision throughout the study (mean BCVA 20/80). 30 operated eyes (75%) showed an initial improvement of CMT. The mean initial CMT was 377.5 ± 105 µm. Improvement during the first month was noted with a mean CMT of 300 ± 55 µm, while the CMT in 10 eyes (25%) remained relatively stable. At 2 months postoperatively, 20 eyes (50%) showed an increased CMT with a mean of 420.5 ± 45 µm and required a second intravitreal injection of 0.5mg ranibizumab. All 40 non-operated control eyes remained stable with a mean CMT was 349 ± 90 µm throughout the study.


Although intravitreal ranibizumab combined with cataract surgery improves the initial visual and anatomical outcome following cataract surgery in patients with DME, recurrence of diabetic macular edema was observed in 50% of patients. Cataract surgery should not be performed in patients with DME unless it is clinically significant to avoid the fluctuation of macular thickness and visual acuity postoperatively. FINANCIAL INTEREST: NONE

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