[Use of triamcinolone and bevacizumab in 25G phaco-vitrectomy surgery for the treatment of cataract and diabetic macular edema].
OBJECTIVE
To evaluate the safety and efficacy of combined phacoemulsification and triamcinolone-assisted vitrectomy with intravitreal injection of bevacizumab in patients with cataract and diffuse diabetic macular edema.


METHODS
In this prospective, non randomized, interventional case series we included 13 eyes of 13 patients with posterior subcapsular cataracts and diffuse macular edema who underwent phacoemulsification, 25G triamcinolone-assisted vitrectomy, endophotocoagulation and had a bevacizumab injection at the end of the procedure. The follow-up consisted of basal best corrected visual acuity, fluorescein angiography, and optical coherent tomography performed at 2 weeks, one, three and six months post-operatively.


RESULTS
An improvement in the best corrected visual acuity of at least two lines was seen in 10 of the 13 patients. The basal average central macular thickness initially was 358.23 micro (SD 50 micro) while at the end of follow-up was 216.6 micro (SD 23.2 micro).


CONCLUSIONS
This combined surgical and pharmacological treatment resulted in an improvement of central macular thickness and non-progression of diabetic retinopathy in the six month follow-up period. Larger comparative studies are necessary to establish the real impact of this therapeutic approach.
Hernández-Da Mota
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SE
Unidad de Oftalmología, Clínica David, Morelia, Mich, México. tolodamota@yahoo.com.mx
Chacón-Lara
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A
Hernández-Vázquez
E
E
D000328:Adult; D000368:Aged; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D002386:Cataract / Q000628:therapy*; D003131:Combined Modality Therapy; D003930:Diabetic Retinopathy / Q000628:therapy*; D004359:Drug Therapy, Combination; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D008269:Macular Edema / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification; D011446:Prospective Studies; D014221:Triamcinolone / Q000627:therapeutic use*; D014821:Vitrectomy
D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D005938:Glucocorticoids; D014221:Triamcinolone; D000068258:Bevacizumab