Prophylaxis Of Macular Edema Research Articles

Prophylaxis of Macular Edema with Preoperative Intravitreal Bevacizumab in Patients with Diabetic Retinopathy Undergoing Phacoemulsification

Purpose: To determine frequency of post-operative macular edema in diabetic retinopathy patients having received preoperative intravitreal bevacizumab, after phacoemulsification cataract surgery while compared with the controls. Study Design: Quasi experimental trial Place and Duration of Study: Department of ophthalmology eye unit 3, KEMU /Mayo hospital, Lahore from March 2020 to August 2020. Methods: A total of 60 patients were included in the study and randomly divided into two groups. Patients of study group were given 1.25mg bevacizumab injection by IV route two weeks priority to surgery while nothing was administered in the control group. Before one week of surgery ocular examination and OCT were perfumed and it was repeated after every month of performance of surgery. Allocation of patients was even not known to the researcher to avoid biasness. Components of monthly examination were best correct visual acuity, slit lamp examination and central macular thickness quantification with OCT. Standard cataract surgery was performed in all the patients (phacoemulsification and implantation of monofocal intraocular lens (IOL)). Post-operatively, all patients were given standard treatment i.e moxifloxacin-dexamethasone). Follow up of all the patients was made for consecutive three months on monthly basis to assess outcome variables i.e macular edema was observed keeping in view central macular thickness. Results: In patients of study group, 16.66% had developed macular edema while in control group it was observed in 46% patients. While comparing macular edema between side of eye, study group had 02 (13.33%) patients belonging to right eye while 03(20.0%) had left eye. However, in control group it was 08 (53.33%) and 06 (40.0%) for right and left eyes respectively. Group A had 230.23 ± 32.16 µm central macular thickness while it was 274.21 ± 25.34 µm in group B. Conclusion: In macular edema prophylaxis using preoperative intravitreal bevacizumab is efficacious in comparison with the controls in patients with mild-moderate edema. Keywords: NPDR, Macular edema, Intravitreal Bevacizumab, Phacoemulsification Surgery, Diabetic Retinopathy.

Prophylaxis of Macular Edema with Peroperative Intravitreal Bevacizumab in Patients with Diabetic Retinopathy Undergoing Phacoemulsification

Purpose: To determine frequency of post-operative macular edema in patients with diabetic retinopathy receiving peroperative Intravitreal bevacizumab, as compared to controls after phacoemulsification cataract surgery.
 Study Design: Randomized control trial.
 Place and Duration of Study: Ophthalmology department holy family hospital Rawalpindi from July, 2016 to January, 2017.
 Materials and Methods: 60 patients who reported at the health care facility with diabetic retinopathy were included in the study. Out of these 30 were kept as control and 30 as cases. Data was collected and entered into SPSS version 19.0. Numerical variables were accounted for as mean and standard deviation whereas qualitative variables were accounted for as frequency and percentages. To compare the occurrence of macular edema at completion of 6 weeks in both study groups, Pearson’s chi-square test at 5% level of significance was applied. A p- value of 0.05 was considered as statistically significant. To control effect modifier by gender, and age, stratified analysis was also executed.
 Results: The participants of the study had mean age of 61.97 ± 5.7 years. Out of the 60 patients 33 (55%) were female. Analysis of both groups showed that macular edema was found in 4 (13.33%) patients in control group and 17 (56.67%) patients in group B. Most significant macular edema was seen in 11 patients in age group of 61-70 years. Gender wise stratification showed that 9 (56.5%) female patients reported with macular edema.
 Conclusion: Peroperative intravitreal bevacizumab is effective in prophylaxis of macular edema in patients with mild to moderate NPDR, as compared to controls,
 Keywords: NPDR, Intravitreal bevacizumab, Diabetic Retinopathy, Macular edema, Phacemulsification surgery.

Prophylaxis of Macular Edema with Intravitreal Ranibizumab in Patients with Diabetic Retinopathy after Cataract Surgery: A Pilot Study

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.