ABSTRACT
Aim: The aim of the study was to assess the effect of combined phacoemulsification and single intraoperative intravitrealinjection of bevacizumab on the central macular thickness (CMT) in diabetic patients.Materials and Methods: A prospective observational study was conducted on 30 eyes with diabetic retinopathy from February2018 to February 2019. All patients underwent thorough ophthalmic evaluation. Phacoemulsification performed by a singlesurgeon using either 0.5% topical proparacaine eye drops or sub-tenon local anesthesia as per the preference of the surgeonin individual case. Bevacizumab 0.05 ml (1.25 mg) was injected intravitreal using a 30-gauge needle through the pars planainto the vitreous cavity after intraocular lens implantation. Patients were followed postoperatively at day 1 then at 1 week and1 month, respectively, for recording the CMT and best corrected visual acuity at 1 month postoperatively.Results: The mean CMT for all the patients at post-operative day 1 and month 1 was 277.96 ± 142.40 μm and 289.50 ± 155.74 μm,respectively. Patients with <10 years of diabetes had mean CMT of 329.09 μm and 318.90 μm, at post-operative day 1 and at1 month, respectively, while those with diabetes more than 10 years had mean CMT of 248.36 μm and 272.47 μm, respectively.In mild non-proliferative diabetic retinopathy (NPDR) and stable proliferative diabetic retinopathy group no significant worseningoccurred in CMT thickness, while in moderate NPDR, four out of 13 cases showed significant increase in CMT (>10%) at 1 month. Insevere NPDR, out of 4 cases 1 case showed significant increase in CMT while other three cases showed modest reduction of CMT.Conclusion: Intravitreal administration of 1.25 mg bevacizumab at the time of cataract surgery is a safe and effective way inavoiding new onset maculopathy in diabetic retinopathy patients. It is also effective to treat pre-existing clinically significantmacular edema and prevent its progression to some extent in few cases.
ABSTRACT
Aim: This study aims to assess central macular thickness (CMT) using optical coherence tomography (OCT) in diabetic patientsbefore and after phacoemulsification.Materials and Methods: A prospective study on 90 diabetic patients conducted from February 2018 to February 2019, whowere all operated for cataract by phacoemulsification. Complete ophthalmological evaluation was done preoperatively. CMTwas measured preoperatively using spectral-domain (SD) OCT. Patients were followed at the 1st post-operative day and at 1, 4,and 6 weeks postoperatively. OCT was done during the 6th week of post-operative period.Results: The mean central 1 mm subfield macular thickness, preoperatively and 6th week postoperatively was 205.12 ± 24.85 µmand 212.79 ± 28.29 µm, respectively. The difference between pre-operative and 6th week post-operative CSMT was significantin all the three groups (no diabetic retinopathy (DR), mild non-proliferative DR [NPDR], and moderate NPDR) (P = 0.001).Conclusion: SD-OCT detected statistically significant increase in mean CMT at 6-week postoperatively in diabetic patientsundergoing phacoemulsification. Precise surgical technique, in the bag implantation of intraocular lens and good post-operativecare, blood sugar control reduces the occurrence of macular edema, resulting in good visual outcome.