First Author: C.Akkin TURKEY
Co Author(s): Z. Oztas S. Nalcaci P. Kiyat F. Afrashi
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The aim of this study is to present the results of the intravitreal DEX implant for the preoperative setting of the cataract surgery in patients with DME and advanced cataract.
Ege University, School of Medicine, Department of Ophthalmology, Bornova, Izmir, Turkey
A retrospective review was performed on patients having centre-involved DME with dense cataract who had received a 0.7 mg DEX implant (Ozurdex®; Allergan, Inc, Irvine, CA) between September 2015 and June 16. Patients were included that subsequently underwent cataract surgery within 2 months of their last DEX implant. In all study eyes, cataracts were prevented the fundus examination significantly and also reduced the visual acuity. The clinical records consisted of best corrected visual acuity (BCVA), slit-lamp biomicroscopy, intraocular pressure (IOP), central foveal thickness (CFT) measurements based on the spectral domain optical coherence tomography (SD-OCT), and complications of the surgical procedures were noted. End point for follow-up was 3 months visit after the cataract removal or re-treatment for recurrent DME occurred before the postoperative 3 months examination.
The mean age of 9 patients (4 female, 5 male) was 67.4 ± 5.8. Eight eyes of the 7 patients had active DME before the DEX implant. The mean CFT was decreased significantly from 469±128 µm to 309±93 µm in those patients (p=0.012). For all eyes, the mean CFT was 286±98 µm before the cataract surgery and 291±107 µm at postoperative one month. This was not significant (p=0.400). The mean CFT was increased to 326±188 µm and 376±176 µm at 2 months and 3 months after the cataract surgery, respectively. Re-treatment was required in patients 1 and 7 at postoperative one month, in patients 2, 4 and 5 at postoperative two months, and in patients 3 (both eyes) and 6 at postoperative three months. The mean time between the DEX implant and cataract removal was 44.9±11.5 days. For recurrent DME, the mean time for re-treatment was 136±68 (median; 119) days after the DEX implant. The mean recurrence time for DME was 92±68 (median; 73) days after the cataract surgery.
Even performing a cataract surgery within 2 months after injection of the 0.7 mg DEX implant the drug was found effective in patients with DME. The median time between the last DEX implant and the re-treatment time based on the SD-OCT measurements was approximately 4 months (119 days).