Switching to Aflibercept in Diabetic Macular Edema after Unsatisfactory Response to Other Anti-vascular Endothelial Growth Factor Drugs

PURPOSE: To evaluate the efficacy of switching to aflibercept in diabetic macular edema (DME) with suboptimal response to previous anti-vascular endothelial growth factor (anti-VEGF) injections. METHODS: A prospective interventional case series study recruited patients from a single center diagnosed with DME with suboptimal response to anti-VEGF injections. Three consecutive monthly injections of aflibercept were performed. The primary outcome measure was mean change in visual acuity after switching to aflibercept. RESULTS: Forty-two patients (42 eyes) were included. Baseline logarithm of the minimum angle of resolution (logMAR) visual acuity was 0.87 ± 0.23 and improved significantly to 0.62 ± 0.29, 0.56 ± 0.34, and 0.46 ± 0.35 at 1, 2, and 3 months, respectively, after the first injection. Mean baseline retinal thickness was 451.57 ± 107.09 µm and decreased significantly at 1, 2, and 3 months after switching to aflibercept (346.52 ± 79.03, 328.24 ± 81.98, and 313.71 ± 85.79 µm, respectively). Both visual improvement and mean change in retinal thickness were significant in patients with pre-aflibercept best-corrected visual acuity less than 1.0 logMAR but were not significant in patients with best-corrected visual acuity more than 1.0 logMAR. CONCLUSIONS: Switching to aflibercept in DME patients with an unsatisfactory response to previous anti-VEGF injections provided acceptable short-term visual and retinal architectural improvement.

Posterior capsule opacification in pseudophakic eyes

To report the incidence of posterior capsule opacification with different types of intraocular lenses. 72 patients [72 eyes] with senile cataract were divided into 3 groups. Their ages ranged between 65 and 72 years. Group I underwent large incision extracapsular cataract extraction [ECCE] and received all PMMA IOL, group II underwent phacoemulsification and received polyacrylic IOL, and group III underwent phacoemulsification and received silicon IOL. All patients were followed up for 2 years to detect PCO. At 2 years PCO was less significant in patients who had implanted polyacrylic IOL than those with silicon or PMMA [P < 0.001]. The lower incidence of PCO with polyacrylic IOL suggests that the IOL material may reduce the incidence of PCO