title: Ranibizumab in patients with dense cataract and proliferative diabetic retinopathy with rubeosis.
abstract: BACKGROUND
  To evaluate the safety of ranibizumab as a surgical adjunct during cataract surgery in patients with proliferative diabetic retinopathy (PDR) with rubeosis, and to evaluate the efficacy and adverse effects of ranibizumab in treating PDR with rubeosis.
  
  
  METHODS
  Three intravitreal injections of 0.5 mg ranibizumab were administered on day-1, months-1 and -2 with cataract surgery 6-16 days after first injection. Retreatments with ranibizumab injections and pan-retinal photocoagulation (PRP) were given if recurrence or persistence of PDR was noted between months-3 and -11. Safety observation visits occurred at months-12, -18 and -24. Primary end points were incidence and severity of adverse events (AEs) that were related to both cataract surgery and treatment of PDR with rubeosis through month -12.
  
  
  RESULTS
  Of six patients screened, four (mean age 61.3 years) were enrolled. No AEs were noted with either cataract surgery or treatment of PDR. Neovascularization of iris (NVI) promptly regressed by 4 days after first ranibizumab injection, prior to cataract surgery in three of four patients (one had significantly regressed NVI by post-injection day-3 visit); NVI was not noted in any patient at 2 weeks after first ranibizumab injection. Recurrence of rubeosis or NVA after 3 monthly injections was not observed in any. At month-12, PDR was not present when assessed clinically and by fluorescein angiogram (FA). Only one patient developed neovascularization of disc and neovascularization elsewhere and required retreatments at months-5 and -9.
  
  
  CONCLUSIONS
  Multiple intravitreal injections of ranibizumab may be a safe, effective treatment adjunct for PDR and diabetes-related rubeosis.
authors: The Institute of Ophthalmology and Visual Science, New Jersey Medical School, 90 Bergen Street Suite 6100, Newark, New Jersey, USA.
authors: Yufei
authors: Y
authors: Tu
authors: Catherine
authors: C
authors: Fay
authors: Suqin
authors: S
authors: Guo
authors: Marco A
authors: MA
authors: Zarbin
authors: Edward
authors: E
authors: Marcus
authors: Neelakshi
authors: N
authors: Bhagat
keywords: Cataract; diabetic retinopathy; neovascularization; ranibizumab; rubeosis iridis