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Visual outcome and central macular thickness after phacoemulsification with intravitreal bevacizumab in patients with diabetic macular edema and cataract

Session Details

Session Title: Vascular Diseases and Diabetic Retinopathy III

Session Date/Time: Friday 12/09/2014 | 16:30-18:00

Paper Time: 17:02

Venue: Boulevard D

First Author: : S.Malhotra INDIA

Co Author(s): :    D. Agarwal   S. Chatterjee   A. Sahu   I. Nanda     

Abstract Details

Purpose:

To evaluate the results of phacoemulsification with intravitreal bevacizumab injection in patients with clinically significant diabetic macular edema and cataract.

Setting:

MGM Eye Institute Raipur, Chhattisgarh ,India

Methods:

In a prospective randomized interventional study,31 patients with significant cataract interfering with macular laser photocoagulation and diabetic macular edema > 300μm were enrolled in the study.Patients had a detailed comprehensive preoperative ocular examination comprising of measurement of best corrected visual acuity(BCVA),intraocular pressure(Goldmann Applanation tonometry) detailed slit lamp biomicroscopy and detailed fundus examination under maximal mydriasis. Grading of cataract was done according to lens opacities classification system III(LOCSIII) and A scan biometry was performed.Central macular thickness (CMT) was measured by stratus 3 optical coherence tomography(OCT.)The diagnosis of clinically significant macular edema(CSME)for all patients was based on ETDRS criteria and the presence of concurrent significant cataract established. Patients were randomized into 2 groups. First group(n=17)underwent phacoemulsification and injection bevacizumab,the other group(n=14), phacoemulsification and SHAM injection.Both groups received focal or modified grid laser photocoagulation after 1 month. Patients were followed up at first and third month with comprehensive ocular examination and OCT.

Results:

The mean of BCVA and CMT at baseline and at 12 weeks were compared by student’s t test and P<0.05 was considered statistically significant.In group I the pre operative mean initial BCVA in LogMAR was 0.9213±0.36 and at post operative 12 weeks was 0.4184±0.24 (P=0.0001).In group II the mean initial BCVA in LogMAR was 0.83±0.36 and at post operative 12 weeks was 0.43±0.17(P=0.002). On comparing mean BCVA in both groups at 12 weeks after surgery from baseline the results were statistically insignificant (P=0.883).The mean preoperative CMT in group I was 436.65±149.02 µm and at post operative 12 weeks was 343.29±118.16 µm(P=0.049). The mean preoperative CMT in group II was 424.21±136.41 µm while at post operative 12 weeks was 400.71±115.54 µm(P=0.168). On comparing CMT between both groups at post operative 12 weeks (P=0.184).Patients in bevacizumab group showed better but statistically insignificant improvement in visual acuity(p=0.883) and CMT(p=0.184) compared to non bevacizumab group.

Conclusions:

Intravitreal bevacizumab at the time of cataract surgery for diabetic macular edema did not give added significant benefit for improving macular edema and visual acuity,

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