Combined cataract surgery and intravitreal dexamethasone implant injection in patients with cataract and diabetic macular edema (DME)

Session Details

Session Title: Cataract Surgery & Retinal Complications

Session Date/Time: Tuesday 25/09/2018 | 16:30-18:00

Paper Time: 17:08

Venue: Room A3, Podium 1

First Author: : V.Vaishnav INDIA

Co Author(s): :    S. Vasavada   S. Srivastava   A. Vasavada   A. Sudhalkar   D. Bhojwani        

Abstract Details

Purpose:

To determine the safety & efficacy of combined cataract surgery with intraocular lens implantation and intravitreal dexamethasone implant injection in patients with DME scheduled for cataract surgery

Setting:

Iladevi Cataract & IOL Reserach centre, Raghudeep Eye Hospital, Ahmedabad, India

Methods:

45 type II diabetic patients with DME and cataract included in this prospective,interventional case series.Patients who had an uneventful cataract surgery included in the study.Patients with co-existent glaucoma, known steroid responders and those with any contraindication to the use of steroids were excluded. All patients received a complete ocular and systemic examination and appropriate investigations. Follow-ups were scheduled on postoperative days 1,7, 30 and then monthly for six months.Additional intravitreal injections were performed as required. Appropriate statistical analysis was done.The outcome measures were change in CDVA and retinal thickness from baseline and the complications

Results:

All patients had well controlled systemic co-morbidities at time of surgery.Median age was 59.24 years.Median CDVA at baseline was 0.54 logMAR.Median preoperative IOP was 13.42 mm Hg.The median preoperative central subfield thickness(CST) on optical coherence tomography(OCT) was 410.2 microns.All patients had an uneventful surgery and injection procedure.The postoperative CDVA improved to 0.13 logMAR(median) at one month.The CST improved to 264.13 microns at one month. Improvements were sustained till the end of follow up in all except 4 patients who required a second injection 3 months after surgery. 6 patients demonstrated an IOP >25 mm Hg. No other complications noted

Conclusions:

Intravitreal dexamethasone implant is a reasonably safe and effective form of therapy for patients with cataract and DME and ensures adequate coverage of macular edema in adult patients with type II DM. The longer duration of action obviates the need for repeat injections in the immediate postoperative period

Financial Disclosure:

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