Prevention of Vision Loss After Cataract Surgery in Diabetic Macular Edema With Intravitreal Bevacizumab

Lanzagorta-Aresti, Aitor; Palacios-Pozo, Elena; Rozalen, José Luis Menezo; Navea, Amparo

doi:10.1097/iae.0b013e31819c6302

Cited by 66 publications

(66 citation statements)

References 22 publications

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“…We hypothesize that intravitreal triamcinolone administration may play a positive role in controlling the acute inflammatory factors that are released following cataract removal. The increase in the CST in the group of patients injected intraoperatively with bevacizumab is consistent with the results achieved by Rauen et al (17) , who did not find a positive anatomical response with intraoperative ranibizumab, in contrast to other similar studies (15)(16)(17)(18)(19) . These results may be related to the high percentage of patients (84.7%) previously treated for DME in this group, as it is known that the presence of DME before the cataract removal is a risk factor for developing macular thickening with this surgical procedure.…”

Section: Discussioncontrasting

confidence: 47%

“…Intravitreal anti-VEGF (bevacizumab or ranibizumab) (15)(16)(17)(18)(19)(20) and intravitreal steroids (triamcinolone acetonide or dexamethasone implant) (20)(21)(22) have been reported to achieve positive anatomical and functional results when injected immediately after the surgical procedure. More recently, the efficacy of topical non-steroidal anti-inflammatory drugs has also been reported (23) .…”

Section: Discussionmentioning

confidence: 99%

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Outcomes of cataract surgery in diabetic patients: results of the Pan American Collaborative Retina Study Group

Gallego-Pinazo¹,

Dolz-Marco²,

Berrocal³

et al. 2014

Arquivos Brasileiros De Oftalmologia

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Purpose: This study was designed to evaluate the visual and anatomical out co mes after cataract surgery in diabetic patients with different intraoperative therapeutic strategies. Methods:The research design comprised of a multicentric, retrospective, interventional study conducted at 6 centers in Argentina, Brazil, Costa Rica, Puerto Rico, Spain, and Venezuela. We included 138 diabetic patients with at least 6-month follow-up following phacoemulsification and intraocular lens implantation. Best-corrected visual acuity (BCVA) and central subfield thickness were collected at baseline and at 1-, 2-, 3-, and 6-month follow-up. Of these, 42 cases were not treated with any intraoperative coadjuvant medication (Group 1), 59 patients received intraoperative bevacizumab (Group 2) and 37 patients received intraoperative triamcinolone (4 mg/0.1 ml) (Group 3). Results: The mean logMAR [± standard deviation (SD)] BCVA improved from 0.82 (± 0.43) at baseline, to 0.14 (± 0.23) at 6-month follow-up (p<0.001) in Group 1; from 0.80 (± 0.48) to 0.54 (± 0.45) (p<0.001) in Group 2; and from 1.0 (± 0.40) to 0.46 (± 0.34) (p<0.001) in Group 3. The mean central subfield thickness increased from 263.57 µm (± 35.7) at baseline to 274.57 µm (± 48.7) at 6-month follow-up (p=0.088) in Group 1; from 316.02 µm (± 100.4) to 339.56 µm (± 145.3) (p=0.184) in Group 2; and from 259.18 µm (± 97.9) to 282.21 µm (± 87.24) (p=0.044) in Group 3. Conclusions: Diabetic patients may significantly benefit from cataract surgery. This study provides evidence to support the use of intravitreal triamcinolone or bevacizumab at the time of cataract surgery in cases with pre-existent diabetic macular edema or moderate-severe non-proliferative diabetic retinopathy. (± 100,4), para 339,56 µm (± 145,3) (p=0,184) no Grupo 2; e de 259,18 µm (± 97,9), para 282,21 µm (±87,24) (p=0,044) cases of severe loss of vision, but diabetic macular edema (DME) is the most prevalent cause of moderate vision loss (2) . It is known that hyperglycemia causes damage to the retinal vascular endothelium, resulting in increased vascular permeability, exudation, and accumulation of extracellular fluid and proteins within the macula, hemorrhages, Keywords

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Section: Discussioncontrasting

confidence: 47%

Section: Discussionmentioning

confidence: 99%

Outcomes of cataract surgery in diabetic patients: results of the Pan American Collaborative Retina Study Group

Gallego-Pinazo¹,

Dolz-Marco²,

Berrocal³

et al. 2014

Arquivos Brasileiros De Oftalmologia

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“…[1][2][3][4] In this case, the IOP increased 77% in the right eye and 124% in the left eye, and CH decreased 41% in the right eye and 30% in the left eye in response to the steroid. After 3 months of withholding topical medication, the IOP and CH resumed normal values.…”

Section: Case Reportmentioning

confidence: 99%

“…[5][6][7] Up to this point in time, few studies have addressed a decrease in CH with topical medications. 1,3,4 There does not seem to be much information regarding ocular hypertension induced by topical corticosteroids in the literature and their impact on CH. 10,11 This, an asymptomatic genetically determined response, is defined as an elevated IOP of greater than 5 mmHg in response to the use of corticosteroid eye drops, ointments, skin preparations, and pills.…”

Section: Introductionmentioning

confidence: 99%

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Decrease Corneal Hysteresis in Steroid-Induced Ocular Hypertension: A Case Report

Molinari

2013

Military Medicine

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Purpose: To describe a case of steroid-induced ocular hypertension in which a clinical significant increase in intraocular pressure resulted with a corresponding corneal hysteresis decreased response. Method: A case report is presented in which a 62-year-old white male who was diagnosed with rosacea meibomitis and treated with topical antibiotic steroid combination ointment responded such. Conclusion: This case report illustrates a reverse model of the topical antiglaucoma medication studies recently described of decrease in intraocular pressure with an increase in corneal hysteresis with the application of topical prostaglandins and beta-blocker compounds. This may provide additional insight into how the biomechanical properties of the cornea and tunics of the eye respond to local applications of different ocular medications.

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Anti-vascular endothelial growth factor for proliferative diabetic retinopathy

Martinez-Zapata

Martí‐Carvajal²,

Solà

et al. 2014

Cochrane Database of Systematic Reviews

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Prevention of Vision Loss After Cataract Surgery in Diabetic Macular Edema With Intravitreal Bevacizumab

Abstract: Intravitreal bevacizumab immediately after phacoemulsification prevents exacerbation of the macular edema seen in many diabetic patients undergoing cataract surgery. In addition, this effect seems to hold in the short term.

Cited by 66 publications

References 22 publications

Outcomes of cataract surgery in diabetic patients: results of the Pan American Collaborative Retina Study Group

Outcomes of cataract surgery in diabetic patients: results of the Pan American Collaborative Retina Study Group

Decrease Corneal Hysteresis in Steroid-Induced Ocular Hypertension: A Case Report

Anti-vascular endothelial growth factor for proliferative diabetic retinopathy

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