Abstract
The purpose of this study was to evaluate the effectiveness of intravitreal ranibizumab (Lucentis, Genentech, South San Francisco, Calif, USA) combined with cataract surgery for the prevention of clinically significant macular edema (CSME) in patients with diabetic retinopathy (DR). This prospective interventional case series included fifty-four eyes of 54 patients with a previous diagnosis of nonproliferative diabetic retinopathy (NPDR) without macular edema preoperatively. Subjects were assigned in a 1 : 1 ratio to receive an intraoperative intravitreal ranibizumab injection (n = 27) or not (control group, n = 27) associated with standardised phacoemulsification surgery. The main outcome measure was the incidence of CSME one and three months after surgery. One month after surgery the incidence of CSME in the control group was 25.92% and 3.70% in the treatment group and at three months was 22.22% and 3.70%, respectively. Short-term results suggest that intravitreal ranibizumab immediately after phacoemulsification prevents CS ME in patients with NPDR.
Highlights
Diabetic macular edema (DME) is a major cause of central visual loss in diabetic patients [1]
The purpose of this study was to evaluate the effectiveness of intravitreal ranibizumab (Lucentis, Genentech, South San Francisco, Calif, USA) combined with cataract surgery for the prevention of clinically significant macular edema (CSME) in patients with diabetic retinopathy (DR)
Kim et al [5] suggested that 22% of diabetic patients develop increases >30% in central retinal thickness measured by optical coherence tomography (OCT) after uncomplicated phacoemulsification
Summary
Diabetic macular edema (DME) is a major cause of central visual loss in diabetic patients [1]. It has been well established by many authors that DME after cataract surgery can difficult visual improvement [2, 3]. Kim et al [5] suggested that 22% of diabetic patients develop increases >30% in central retinal thickness measured by optical coherence tomography (OCT) after uncomplicated phacoemulsification. Many studies proposed the used of intravitreal bevacizumab or intravitreal steroids after phacoemulsification in patients with DME to prevent the increase in retinal thickening and to improve the DME and final visual acuity [6,7,8]. We injected Ranibizumab, effective in the treatment of wet macular degeneration and macular edema [9,10,11,12], immediately after phacoemulsification in diabetic patients with some degree of diabetic retinopathy without macular involvement and studied the macular thickness and morphology by OCT 1 and 3 months after surgery
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