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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



Purpose:

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.

Setting:

AL Oyoun Al Dawli Hospital, Dokki, Giza - Egypt

Methods:

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.

Results:

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.

Conclusions:

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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