Prevention of vision loss after cataract surgery in diabetic macular edema with intravitreal bevacizumab: a pilot study.
OBJECTIVE
To determine whether an intravitreal bevacizumab injection after phacoemulsification can improve cataract surgery visual outcomes in patients with diabetic macular edema by acting on the degree of edema.


METHODS
Fundación Oftalmológica del Mediterráneo, Valencia, Spain.


METHODS
We selected 26 consecutive diabetic patients with nonproliferative diabetic retinopathy and macular edema who were to undergo cataract surgery, and we divided them into two randomized groups to be studied prospectively. Group I included 13 eyes that were injected with intravitreal bevacizumab upon completion of cataract surgery; Group II included 13 control eyes that were injected with balanced salt solution.


RESULTS
Preoperative macular thickness was 282.62 microm +/- 57.64 in Group I and 310.38 microm +/- 82.99 in Group II. Preoperative Snellen best-corrected visual acuity was 0.27 +/- 0.17 and 0.24 +/- 0.16 in Groups I and II, respectively. Best-corrected visual acuity at 3 and 6 months was better in Group I--0.4 +/- 0.28 and 0.4 +/- 0.27--whereas poorer results were observed in the control group--0.21 +/- 0.13 and 0.14 +/- 0.13. These mean macular thickness values differed significantly between groups at 3 months (P = 0.040) and 6 months (P = 0.004). Optical coherence tomography measured macular thickness was also better in Group I, 292.46 +/- 104.75 microm at 3 months and 277.62 +/- 92.99 microm at 6 months. For Group II, the results were 367.62 +/- 75.24 microm at 3 months and 387.46 +/- 74.11 microm at 6 months. These mean macular thickness values differed significantly between groups at 3 months (P = 0.046) and 6 months (P = 0.002).


CONCLUSIONS
Intravitreal bevacizumab immediately after phacoemulsification prevents exacerbation of the macular edema seen in many diabetic patients undergoing cataract surgery. In addition, this effect seems to hold in the short term.
Lanzagorta-Aresti
Aitor
A
Fundacion Oftalmologica del Mediterraneo, Valencia, Spain. aitorlanzagorta@hotmail.com
Palacios-Pozo
Elena
E
Menezo Rozalen
Jose Luis
JL
Navea-Tejerina
Amparo
A
D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D002387:Cataract Extraction / Q000009:adverse effects*; D003930:Diabetic Retinopathy / Q000188:drug therapy* / Q000503:physiopathology; D018450:Disease Progression; D006801:Humans; D007267:Injections; D008269:Macular Edema / Q000188:drug therapy* / Q000503:physiopathology; D010865:Pilot Projects; D011182:Postoperative Care; D011184:Postoperative Period; D011300:Preoperative Care; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014786:Vision Disorders / Q000209:etiology* / Q000517:prevention & control*; D014792:Visual Acuity; D014822:Vitreous Body
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab