Diabetic retinopathy progression 6 months post‐cataract surgery with intravitreous bevacizumab vs triamcinolone: A secondary analysis of the DiMECAT trial. (31st May 2020)

• Record Type: Journal Article
• Authors: Sasongko, Muhammad B.; Rogers, Sophie; Constantinou, Marios; Sandhu, Sukhpal S.; Wickremasinghe, Sanjeewa S.; Al‐Qureshi, Salmaan; Lim, Lyndell L.
• Is Part Of: Clinical & experimental ophthalmology. Volume 48:Number 6(2020)
• Page Start: 793
• Page End: 801
• Publication Date: 2020-05-31
• Subjects: cataract surgery -- diabetic retinopathy -- intravitreal bevacizumab -- intravitreal triamcinolone acetonide; Ophthalmology -- Periodicals; 617.7
• DOI: 10.1111/ceo.13771
• Languages: English
• ISSNs: 1442-6404

Abstract

ABSTRACT: 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 Measures: DR progression. Results: There were 61 eyes included. Patients receiving BVB were older than those receiving TCA (70.2 vs 64.3 years; P < .05). Three participants (10.7%) in the BVB and three (9.09%) in the TCA group had a one‐step progression, while none in BVB and only one (3%) in the TCA group demonstrated two‐step DR progression. In the majority of these patients, DR progression was from mild to moderate non‐proliferative diabetic retinopathy. 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 intraoperative intravitreous BVB or TCA injection to reduce the risk of DR progression following cataract surgery.