title: Dexamethasone intravitreal implant at the time of cataract surgery in eyes with diabetic macular edema.
abstract: OBJECTIVE
  To determine the potential role of intraoperative dexamethasone intravitreal implant (DEX-I) in reducing diabetic macular edema (DME) worsening after phacoemulsification.
  
  
  METHODS
  This was a prospective study on 19 eyes of 19 patients with type 2 diabetes mellitus with DME and cataract. Mean preoperative Early Treatment Diabetic Retinopathy Study visual acuity (VA) was 16.7 letters. Mean foveal thickness (FT) was 451 μm. The DME was naive in 11 eyes and refractory in 8 eyes. All eyes underwent a standard phacoemulsification and intraocular lens implantation; DEX-I was injected at the end of surgery. Follow-up was performed at 1 week and then monthly until DME recurrence (up to 8 months).
  
  
  RESULTS
  At 1 week, mean VA improved by 15 letters (range 0-29 letters) and mean FT decreased by 147 μm (range 69-236 μm). Improvement consolidated at month 1, with a mean VA improvement of 18 letters (range 3-32 letters) and a mean improvement in FT of 193 μm (range 76-304 μm), remaining stable at month 2 after surgery in all eyes. The DME recurred in 1 eye at month 3, in 14 eyes (73.8%) between months 4 and 5, and after month 6 in 4 eyes (21%). Refractory DMEs demonstrated the same benefit but recurred earlier than naive ones (4 months versus 5.8 months, p<0.01).
  
  
  CONCLUSIONS
  Intraoperative DEX-I prevents DME worsening after phacoemulsification. Its positive effects last for at least 3 months.
authors.affiliation: Ophthalmology Unit, Bussolengo Hospital, Bussolengo (Verona) - Italy.
authors.forename: Giacomo A
authors.initials: GA
authors.lastname: Panozzo
authors.affiliation: Department of Ophthalmology, University of Medicine, Verona - Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Gusson
authors.affiliation: School of Medicine, University of Parma, Parma - Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Panozzo
authors.affiliation: Ophthalmology Unit, Bussolengo Hospital, Bussolengo (Verona) - Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Dalla Mura
mesh_terms: D000368:Aged; D003692:Delayed-Action Preparations / Q000008:administration & dosage; D003907:Dexamethasone / Q000008:administration & dosage*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D003930:Diabetic Retinopathy / Q000188:drug therapy* / Q000503:physiopathology; D004343:Drug Implants; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D058449:Intravitreal Injections; D019654:Lens Implantation, Intraocular; D008269:Macular Edema / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D059035:Perioperative Period; D018918:Phacoemulsification / Q000009:adverse effects; D011446:Prospective Studies; D014792:Visual Acuity / Q000502:physiology
chemical_list: D003692:Delayed-Action Preparations; D004343:Drug Implants; D005938:Glucocorticoids; D003907:Dexamethasone