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Combined Phacoemulsification and Intravitreal Dexamethasone Is an Effective Option for High-Risk Diabetic Macula Oedema Patients
Objective Cataract surgery in diabetic patients carries an increased risk of post-operative macula oedema, particularly in those with a history of diabetic macula oedema (DMO) treatment or DMO at the time of surgery. We investigated whether simultaneous phacoemulsification with intravitreal Ozurdex...
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Published in: | Curēus (Palo Alto, CA) CA), 2021-08, Vol.13 (8), p.e17603-e17603 |
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Main Authors: | , , |
Format: | Article |
Language: | English |
Subjects: | |
Citations: | Items that this one cites |
Online Access: | Get full text |
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Summary: | Objective
Cataract surgery in diabetic patients carries an increased risk of post-operative macula oedema, particularly in those with a history of diabetic macula oedema (DMO) treatment or DMO at the time of surgery. We investigated whether simultaneous phacoemulsification with intravitreal Ozurdex
®
reduces the risk of developing new, or deteriorating current, DMO.
Methods
We conducted a retrospective review of 79 consecutive ‘high-risk’ diabetic patients who underwent phacoemulsification with intraocular lens insertion and intravitreal Ozurdex
®
implantation immediately subsequently. ‘High risk’ was defined as diabetic patients with prior treatment history for DMO or current DMO. Central macula thickness (CMT), best-corrected visual acuity and intraocular pressure were recorded pre-operatively, at two to four weeks and at three months post-operatively. A significant change in CMT was defined as a change of ≥0.1 LogOCT units.
Results
The mean age was 72.6 years; 52% were males. The mean pre-operative CMT was 365um. Thirty-seven per cent (37%) patients had prior DMO history that had resolved; 63% had confirmed DMO in surgery. Two to four weeks post-operatively, 82% of patients had stable CMT and 18% showed improvement. No patients deteriorated. Three months post-operatively, 48% of patients had stable CMT relative to pre-operative measurements, 38% improved, and 14% deteriorated. Analysis of variance (ANOVA) indicated no significant differences in response with demographical or pathological factors, including diabetic retinopathy grade and treatment history.
Conclusion
Phacoemulsification surgery combined with Ozurdex
®
insertion at the end of the procedure is a highly effective strategy for protecting against the formation of new, or the deterioration of current DMO, in the highest risk diabetic patients undergoing cataract surgery. |
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ISSN: | 2168-8184 2168-8184 |
DOI: | 10.7759/cureus.17603 |