TJ-CEO
2018 , Vol 13 , Num 4
Adjuvant Therapies for Diabetic Retinopathy Patients Undergoing Cataract Surgery: a Summary of Current Evidence
1Yrd. Doç. Dr., Marmara Üniversitesi Tıp Fakültesi, Göz Hastalıkları, İstanbul, Türkiye2Yrd. Doç. Dr., Medeniyet Üniversitesi Tıp fakültesi, Göz Hastalıkları, İstanbul, Türkiye
3Prof. Dr., Marmara Üniversitesi Tıp Fakültesi, Göz Hastalıkları, İstanbul, Türkiye Aim of this study, review the current evidence on cataract surgery in patients with diabetic retinopathy (DRP) and effect of adjunctive treatment modalities. A standardized PubMed search was performed and the articles with the highest level of evidence on each clinical scenario or treatment modality were selected for the purpose of this review. The progression of diabetic retinopathy or the risk of developing of macular edema was not reported to increase after phacoemulsifi cation cataract surgery. In patients with preexisting diabetic macular edema, cataract surgery was shown to increase macular edema. Adjunctive treatment with intraoperative intravitreal administration of anti-VEGF agents (bevacizumab, ranibizumab) or steroids (triamcinolone, dexamethasone implant) was shown to prevent worsening of diabetic macular edema. Current evidence indicated that an adjunctive treatment is only needed in cases with preexisting diabetic macular edema when performing cataract surgery in diabetic retinopathy patients. While only intravitreal treatment modalities showed improvement in macular edema in such cases, there is no study available comparing the effi cacy or safety of the above-mentioned treatment options when administered simultaneously with cataract surgery. Keywords : Bevacizumab, cataract surgery in diabetic patients, diabetic macular edema, intravitreal steroids, ranibizumab