title: Intravitreal injection of ranibizumab during cataract surgery in patients with diabetic macular edema.
abstract: OBJECTIVE
  To investigate macular thickness and visual acuity changes after 1 intravitreal injection of 0.5-mg ranibizumab during phacoemulsification cataract surgery in eyes with diabetic macular edema refractory to laser treatment.
  
  
  METHODS
  Eleven eyes of 11 patients with diabetic macular edema refractory to modified Early Treatment Diabetic Retinopathy Study laser therapy received intravitreal during phacoemulsification cataract surgery. Comprehensive ophthalmic evaluation was performed preoperatively and at 1, 4, 8 ± 1, and 12 ± 2 weeks postoperatively. Main outcome measures included central subfield thickness and best-corrected Early Treatment Diabetic Retinopathy Study visual acuity.
  
  
  RESULTS
  Eleven patients completed the 12-week study visit. Mean central subfield thickness (± SEM) was 399.82 ± 29.50 μm at baseline and did not change significantly at any postoperative study visit (P > 0.05). Mean (± SEM) best-corrected Early Treatment Diabetic Retinopathy Study visual acuity was 0.95 ± 0.13 logarithm of the minimum angle of resolution (20/200) at baseline and was significantly improved at Weeks 1 (0.38 ± 0.13), 4 (0.38 ± 0.11), 8 (0.35 ± 0.08), and 12 (0.46 ± 0.12) after treatment (P < 0.05).
  
  
  CONCLUSIONS
  In this case series of patients with diabetic macular edema refractory to laser therapy, intravitreal ranibizumab administered during cataract surgery was associated with no significant change in central subfield thickness postoperatively. Significant improvement in best-corrected Early Treatment Diabetic Retinopathy Study visual acuity was observed after treatment, likely because of cataract removal.
authors.affiliation: Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
authors.forename: Paulo I
authors.initials: PI
authors.lastname: Rauen
authors.forename: Jefferson A S
authors.initials: JA
authors.lastname: Ribeiro
authors.forename: Felipe P P
authors.initials: FP
authors.lastname: Almeida
authors.forename: Ingrid U
authors.initials: IU
authors.lastname: Scott
authors.forename: André
authors.initials: A
authors.lastname: Messias
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Jorge
mesh_terms: D000368:Aged; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage*; D002386:Cataract / Q000150:complications / Q000503:physiopathology; D003930:Diabetic Retinopathy / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007429:Intraocular Pressure; D058449:Intravitreal Injections; D019654:Lens Implantation, Intraocular; D008269:Macular Edema / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D018918:Phacoemulsification; D011446:Prospective Studies; D000069579:Ranibizumab; D012160:Retina / Q000473:pathology; D041623:Tomography, Optical Coherence; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity / Q000502:physiology
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000069579:Ranibizumab