The timing of intravitreal Ranibizumab therapy after cataract surgery in patient with diabetic macular edema

Abstract

Objective To investigate the timing of intravitreal ranibizumab injection after phacoemulsification for the patients with diabetic macular edema (DME). Methods Forty-six eyes of 46 patients with DME who underwent phacoemulsification surgery were randomly divided into observation group (n=25) and control group (n=21). An intravitreal injection of ranibizumab (0.05 ml of solution at 10 mg /ml) was performed immediately after cataract surgery in the patients of observation group, and 4 weeks after surgery in control group. The main outcome measures included the best corrected visual acuity (BCVA), central retina thickness (CRT), macular edema grades, intraocular pressure (IOP) and blood sugar. Results Before phacoemulsification surgery, BCVA (logMAR) in observation group and control group were 0.67±0.15 and 0.70±0.21 respectively (t=1.013, P>0.05). But 16 weeks after phacoemulsification surgery, the BCVA (logMAR) in observation group was 0.45±0.35 which was better than that 0.51±0.27 in control group (t=5.239, P<0.05). The CRT in observation group and control group were changed from preoperative (495.93±203.71) μm and (501.32±172.65) μm to postoperative (435.93±190.46) μm and (441.85±188.54) μm, respectively. Meanwhile, CRT in observation group was better than that in control group after intraviteal ranibizumab injection. Comparing with that before injection, the percentage of DME patients was decreased to 80% in observation group, but it was unchanged in control group 4 weeks after intravitreal ranibizumab injection. No complication, such as endophthalmitis, retinal hemorrhage, retinal detachment, ocular hypertension or systemic thrombosis occurred in the patients of two groups after ranibizumab injection. Conclusion The treatment of intravitreal ranibizumab after phacoemulsification is effective for patients with DME and Ranibizumab injection should be performed after cataract surgery immediately, thus is better for DME treatment. Key words: Diabetes, type 2; Edema, macular; Phacoemulsification; Ranibizumab, intravitreal injection