combination of phacoemulsification surgery and intravitreal triamcinolone injection in patients with cataract and diabetic macular edema

Purpose: To assess the safety and efficiency of combined phacoemulsification [PHACO] surgery and intravitreal triamcinolone [IVTA] injection with or without macular grid laser photocoagulation in patients with cataract and diabetic macular edema

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Material and methods: This prospective study included 41 eyes of 36 diabetic patients with cataract and coexisting clinically significant macular edema [CSME]. After PHACO and IVTA injection eyes were divided into two groups: the laser and IVTA group [Group 1] and only IVTA group [Group 2]. Preoperative and postoperative best corrected visual acuity [BCVA], central macular thickness [CMT], and intraocular pressure [IOP] were recorded. Paired sample t-test was used to compare data in the groups and C square test for qualitative variables

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Results: Postoperative BCVA was significantly higher than the initial BCVA during the follow-up period in both groups [p < 0.01]. The BCVA 6 months after surgery was significantly higher in group 1 than in group 2 [p < 0.01]. There was no statistically significant difference in IOP between two groups preoperatively and postoperatively during the follow-up period [p > 0.05]. There was no statistically significant difference between both groups in mean CMT preoperatively and 2nd week, 2nd month and 3rd month after surgery [p > 0.05]. The mean CMT 6 months after surgery was statistically significantly lower in group 1 than in group 2 [p < 0.01]

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Conclusions: PHACO surgery combined with IVTA injection improves BCVA and provides a decrease in CMT in diabetic patients with CSME. Additional macular grid laser photocoagulation after surgery helps to preserve this improvement in BCVA and decrease in CMT