The combination of intravitreal bevacizumab and phacoemulsification surgery in patients with cataract and coexisting diabetic macular edema.
OBJECTIVE
The aim of this study was to assess the efficacy of phacoemulsification combined with intravitreal (i.v.t.) bevacizumab injection in diabetics with clinically significant macular edema (CSME) and cataract.


METHODS
This retrospective study included diabetic patients with cataract and CSME who underwent phacoemulsification and intraocular lens implantation with a 2.5-mg bevacizumab i.v.t injection (ivBe) (15 eyes) or without ivBe (controls, 14 eyes). Best-corrected visual acuity (BCVA), central macular thickness (CMT) measured by optic coherence tomography (OCT), and adverse events were recorded.


RESULTS
In the ivBe group, the OCT images demonstrated that CMT (mean +/- standard deviation [SD]) decreased significantly from 466 +/- 105 at baseline to 333 +/- 107, 313 +/- 138 and 333 +/- 111 microm at 4, 8, and 12 weeks, respectively, after treatment (P < 0.05). The visual acuity in logMAR (mean +/- SD) improved significantly from 1.66 +/- 0.39 at baseline to 1.30 +/- 0.50, 1.15 +/- 0.42, 0.99 +/- 0.48, and 1.03+/- 0.44 at 1, 4, 8, and 12 weeks, respectively, after treatment (P < 0.05). However, in the control group, the CMT changed insignificantly from 443 +/- 109 at baseline to 463 +/- 106, 425 +/- 128, and 421 +/- 119 microm at 4, 8 and 12 weeks, respectively after treatment (P > 0.05). The visual acuity in logMAR improved insignificantly from 1.63 +/- 0.42 at baseline to 1.43 +/- 0.53, and 1.39 +/- 0.43 at 1, and 4 weeks (P > 0.05) and significantly to 1.24 +/- 0.45 and 1.18 +/- 0.44 at 8 and 12 weeks, respectively, after treatment (P < 0.05). None of the patients in both groups experienced injection- or surgery-related complications or any obvious systemic adverse events.


CONCLUSIONS
The short-term results suggest that phacoemulsification with i.v.t. bevacizumab safely reduces macular edema and improves visual acuity for cataract and CSME in diabetics.
Chen
Chih-Hsin
CH
Department of Ophthalmology, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan, People's Republic of China.
Liu
Ya-Chi
YC
Wu
Pei-Chang
PC
D000368:Aged; D020533:Angiogenesis Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D002386:Cataract / Q000150:complications / Q000628:therapy*; D003131:Combined Modality Therapy; D003930:Diabetic Retinopathy / Q000150:complications*; D005260:Female; D006801:Humans; D007267:Injections; D019654:Lens Implantation, Intraocular; D008269:Macular Edema / Q000150:complications* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D014792:Visual Acuity; D014822:Vitreous Body
D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab