Phacoemulsification Combined With Intravitreal Dexamethasone Implant - A Retrospective Analysis Of 31 Eyes

The study purpose was to analyse the outcomes of cataract surgery by phacoemulsification when combined with dexamethasone (Ozurdex) implant. 

This study was conducted at tertiary referral eye care hospital in western India. Patients had cataract with coexisting macular edema secondary to diabetic retinopathy, retinal vein occlusion, or uveitis. 

This was a retrospective analysis of patients operated at a tertiary care hospital, which underwent phacoemulsification combined with dexamethasone implant. 31 eyes of 27 patients operated over a 7-year period could be identified and were included for further analysis. Data analyzed included demographic data along with indication for dexamethasone implant, preoperative and postoperative visual acuity, intraocular pressure, and optical coherence tomography (OCT) parameters. 

Indications for using intravitreal Dexamethasone implant were coexisting diabetic macular edema (n=22 eyes), macular edema due to retinal vein occlusion (n=5), and uveitis (n=4). The mean follow-up duration was 25 months (1-88 months). Visual acuity one month after surgery improved in 25 eyes, was unchanged in 3, and reduced in 3 eyes (mean +0.5logMAR, range -0.5 to +1.6). The mean change in intraocular pressure was +0.7 mmHg (range -4 to +6); one patient required addition of anti-glaucoma medication. Re-intervention was required in 12 eyes, and was performed at a mean of 11.4 months after surgery. 

The combined use of intravitreal Dexamethasone implant with cataract surgery appears to be safe and effective in the management of macular edema due to varied indications. A single sitting approach also reduces patient visits and may improve acceptance of therapy.