title: Deferred intravitreal triamcinolone in diabetic eyes after phacoemulsification.
abstract: OBJECTIVE
  Evaluation of diabetic macular edema (DME) after phacoemulsification by optical coherence tomography (OCT) and the use of deferred intravitreal triamcinolone acetonide (IVTA) as a therapy.
  
  
  METHODS
  This was an institutional, nonrandomized, retrospective study. Within a period of 18 months, 5,684 eyes underwent phacoemulsification in our department, 1,634 of which were diabetic. Eight weeks after surgery, 55 out of 1,634 diabetic eyes that had undergone phacoemulsification developed DME and were treated with a 3.2 mg IVTA injection. The mean best-corrected visual acuity (BCVA) and mean central macular thickness (CMT) were measured before and after phacoemulsification and 3 months after IVTA.
  
  
  RESULTS
  The mean BCVA at baseline, after phacoemulsification, and 3 months after deferred IVTA was 49.0±17.7, 53.7±17.4, and 66.36±20.66, respectively. The mean CMT for the same endpoints was 268.9±76.3, 554.6±137.8, and 275.0±76.3 μm, respectively. Eyes were subdivided into 2 subgroups: eyes with a previous history of DME and eyes with de novo DME. Three months after deferred IVTA, there was a statistically significant difference between these 2 subgroups in BCVA (P<0.001) and in CMT (P=0.002). The OCT features before and after IVTA defined 2 subgroups of DME, with respect to cyst color and symmetry and OS/IS line integrity after IVTA.
  
  
  CONCLUSIONS
  Our data suggest that DME progresses after uncomplicated phacoemulsification in diabetic eyes and that IVTA is an appropriate therapeutic tool. The response to IVTA treatment depends on previous history of DME and its OCT profile.
authors.affiliation: Department of Ophthalmology, Centro Hospitalar de Leiria Pombal , Leiria, Portugal .
authors.forename: António
authors.initials: A
authors.lastname: Campos
authors.forename: Diana
authors.initials: D
authors.lastname: Beselga
authors.forename: Sílvia
authors.initials: S
authors.lastname: Mendes
authors.forename: Joana
authors.initials: J
authors.lastname: Campos
authors.forename: Arminda
authors.initials: A
authors.lastname: Neves
authors.forename: Paulo
authors.initials: P
authors.lastname: Sousa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003930:Diabetic Retinopathy / Q000188:drug therapy* / Q000503:physiopathology; D018450:Disease Progression; D005260:Female; D006801:Humans; D058449:Intravitreal Injections; D008269:Macular Edema / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification / Q000379:methods*; D012189:Retrospective Studies; D013997:Time Factors; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014222:Triamcinolone Acetonide / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D014222:Triamcinolone Acetonide