DIABETIC MACULAR EDEMA AND CATARACT SURGERY: PHACOEMULSIFICATION COMBINED WITH DEXAMETHASONE INTRAVITREAL IMPLANT COMPARED WITH STANDARD PHACOEMULSIFICATION

Purpose To compare functional and anatomical results of combined phacoemulsification and dexamethasone intravitreal implant (Ozurdex; DEX-I) with standard phacoemulsification in diabetic patients with cataract. Methods Retrospective, comparative, cohort study. Patients with non-proliferative diabetic retinopathy, macular edema (ME), and cataract, treated routinely at the Eye Clinic, Azienda Ospedaliero Universitaria Policlinico, Bari, Italy with phacoemulsification associated with DEX-I (n=23; Phaco-Dex) or standard phacoemulsification (n=23; Phaco-alone). Best-correct visual acuity (BCVA), central subfield thickness (CST), and intraocular pressure (IOP) were assessed at baseline and monthly for 3 months after surgery, and t-test was used to assess change from baseline. A multilevel regression model with an unstructured correlation-type matrix to account for repeated data measures was used for statistical analysis in and between groups. Results With Phaco-Dex, BCVA increased significantly from the first month (P=0.0005 vs baseline) and remained stable at the following visits; CST decreased significantly from month 2 (P=0.049 and P=0.04 vs baseline, respectively); at each timepoint, CST was significantly lower in the Phaco-Dex group vs. Phaco-alone. IOP increased significantly during follow-up (P=0.001 at month 3 vs baseline) but remained within the normal range. In the Phaco-alone group, BCVA, and IOP did not show any significant changes after surgery, while CST increased from month 2 (P=0.05 vs baseline). Conclusion In diabetic patients with ME and visually significant cataract, combined treatment with phacoemulsification and DEX-I seemed to be effective, safe and superior to standard phacoemulsification considering both functional and tomographic parameters.