Sub-Tenon's injection of betamethasone for CME prevention in diabetic patients after uneventful phacoemulsification

Session Details

Session Title: Presented Poster Session: Cataract Surgery Complications and Management

Session Date/Time: Saturday 05/09/2015 | 09:30-10:50

Paper Time: 10:20

Venue: Poster Village: Pod 1

First Author: : A.Martsinkevich RUSSIA

Co Author(s): :    B. Malyugin   O. Goncharenko   E. Zimina        

Abstract Details

Purpose:

To assess the effect of a single sub-Tenon betamethasone injection at the completion of the procedure on the macular function and morphology in diabetic patients after uneventful phacoemulsification and in-the-bag IOL implantation.

Setting:

S. Fyodorov Eye Microsurgery Complex Federal State Institution, Krasnodar, Moscow, Russian Federation

Methods:

86 patients (98 eyes)with diabetes mellitus and nonproliferative diabetic retinopathy were randomized into 2 groups. After uneventful phacoemulsification, patients of group A (44 patients, 51 eyes) received 7 mg of betamethasone by sub–Tenon's capsule injection, while patients of group B (42 patients, 47 eyes) were assigned to the tapered scheme (4-3-2-1) of topical 0,1% dexamethasone for 1 month. The foveal thickness and the volume of the macula were assessed by OCT at 1 day, 2 weeks, 1,5 and 3 months after surgery. As a reference parameters data obtained on day 1 after phacoemulsification were taken.

Results:

There were no significant differences between 2 groups in IOP 1 day postoperatively. IOP difference in between 2 groups was statistically significant on days 3 and 14 (18.8±1.2; 18.4±1.3 in group A and 22.0±1.3; 20.1±1.4 in group B respectively; p=0.0001). There was a significant increase in the foveal thickness in both groups at 1,5 and 3 months after surgery (11.1±12.9; 15.9±12.7 μm in group A and 23.33±12.5; 26.61±12.3 μm in group B respectively), but in group B this was almost 2-fold higher (p=0.0004). Increase in the macular volume was also significantly different from baseline in both groups at 1,5 and 3 months, the tendency was greater in the group B.

Conclusions:

Sub-Tenon injection of betamethasone prevents the increase of the central retinal thickness in diabetic patients after uneventful phacoemulsification. There were no significant differences between 2 groups in BCVA at any follow-up visit. Clinically significant macular edema, leading to decrease of visual acuity was not observed in any case. The relevance of this finding on the prevention of CME should be further investigated in a larger clinical series.

Financial Interest:

NONE