First Author: G.Murthy INDIA
Co Author(s): P. Mahajan C. Pujar N. Varda
Back to previous
To analyse the effect of single intraoperative intravitreal injection of bevacizumab on central macular thickness in diabetes mellitus patients undergoing phacoemulsification cataract surgery under local anaesthesia.
Patients (Type-2 diabetes mellitus) from the Mysore city and surrounding suburban area attending the general ophthalmic and retina OPD of Mysore Race club EyeHospital above 40 years of age having visually significant cataract from December 2014 to June 2016..
A prospective intervention and observational study. Thirty diabetic patients with sight-limiting cataract and poor fundus view precluding adequate monitoring and/or laser therapy underwent Phacoemulsification with intra-operative intravitreal bevacizumab (1.25mg/0.05cc) injection. Diabetic patients with non-proliferative diabetic retinopathy (NPDR) and stable proliferative diabetic retinopathy (PDR) according to the established criteria by the ETDRS with adequate metabolic control were only included. Patients had their baseline oct 1 day before or immediately after their surgery where view was hazy due to cataract. Subsequent OCT was done after 1 week and 1 month after surgey.
In the present study sixth decade (60-70) was the most common age group who underwent cataract surgery. Also, a male preponderance was noted. Those with < 10 years diabetes had a mean decrease of central retinal thickness of 10.19 µm value while those with diabetes of ≥ 10 year duration had a mean increase of 24.11 µm at one month postoperatively. In those with ≥ 10 year diabetic age group out of 19 cases 2 cases showed loss of at least one line and in 2 more cases there was no change in VA and the rest 15 cases showed improvement of ≥2 lines of VA (with P value < 0.05). While all patients with diabetic age <10 year gained ≥ 3 lines (P = 0.00). Increase in CRT occurred in 16.65% of the eyes at the end of one month. All these cases (16.7%) who showed increased thickness at one month had baseline central macular thickness of >250µm.
1. Intravitreal administration of 1.25 mg bevacizumab at the time of cataract surgery is a safe and effective way in avoiding new onset of maculopathy in diabetic retinopathy patients. 2. It is also effective to treat preexisting CSME and prevent its progression to a certain extent. 3. Better Visual outcomes are achieved if intravitreal bevacizumab is administered at the time of cataract surgery in diabetic retinopathy patients with normal central macular thickness. 4. In the present study 86.65% showed significant gain in visual acuity at one month (P = 0.00). 4. Some of those with preexisting central retinal thickening will require further treatment for the diabetic maculopathy.