Diabetic retinopathy progression 6 months post cataract surgery with intravitreous bevacizumab vs triamc1inolone: A secondary analysis of the DiMECAT trial.

IMPORTANCE: Diabetic retinopathy (DR) may progress following cataract surgery due to surgery-induced inflammation. The effect of intravitreal bevacizumab (BVB) and triamcinolone acetonide (TCA), which have differing anti-inflammatory properties, on DR progression following cataract surgery has not been reported. BACKGROUND: To report the progression of DR in diabetic patients undergoing cataract extraction treated with intravitreal BVB or TCA during the surgery. DESIGN: Post-hoc analysis of 6 month data from a prospective, randomized, double-masked clinical trial PARTICIPANTS: Diabetic patients with clinically significant cataract and fovea involving diabetic macular oedema (DME), or a recent history of DME. METHODS: Participants were randomly allocated 1:1 to receive intravitreal BVB 1.25 mg or TCA 4 mg during and post cataract surgery as needed. The rate of DR progression between groups was compared. MAIN OUTCOME MEASURE(S): DR progression RESULTS: There were 61 eyes included. Patients receiving BVB were older than those receiving TCA (70.2 vs 64.3 years; P < 0.05). Three participants (10.7%) in the BVB and three (9.09%) in the TCA group had a 1-step progression, while none in BVB and only one (3%) in the TCA group demonstrated 2-step DR progression. In the majority of these patients, DR progression was from mild to moderate NPDR. CONCLUSION AND RELEVANCE: In this study, BVB and TCA groups had a similar, and lower rate of DR progression compared to previous studies where no adjunctive treatment was administered, suggesting that patients with DME may benefit from either intra-operative intravitreous BVB or TCA injection to reduce the risk of DR progression following cataract surgery. This article is protected by copyright. All rights reserved.