Randomized controlled European multicenter trial on the prevention of cystoid macular edema after cataract surgery in diabetics: ESCRS PREMED Study Report 2. Issue 7 (July 2018)

• Record Type: Journal Article
• Authors: Wielders, Laura H.P.; Schouten, Jan S.A.G.; Winkens, Bjorn; van den Biggelaar, Frank J.H.M.; Veldhuizen, Claudette A.; Murta, Joaquim C.N.; Goslings, Willem R.O.; Kohnen, Thomas; Tassignon, Marie‐José; Joosse, Maurits V.; Henry, Ype P.; Nagy, Zoltán Z.; Rulo, Alexander H.F.; Findl, Oliver; Amon, Michael; Nuijts, Rudy M.M.A.
• Is Part Of: Journal of cataract and refractive surgery. Volume 44:Issue 7(2018)
• Publication Date: 2018-07
• Subjects: 617.7
• DOI: 10.1016/j.jcrs.2018.05.015
• Languages: English
• ISSNs: 0886-3350

Abstract

Abstract : Purpose : To compare the efficacy of perioperative treatment strategies, in addition to topical bromfenac 0.09% and dexamethasone 0.1%, to reduce the risk for developing cystoid macular edema (CME) after uneventful cataract surgery in diabetic patients. Setting : Twelve European study centers. Design : Randomized clinical trial. Methods : Diabetic patients having phacoemulsification cataract surgery were randomly allocated to receive no additional treatment, a subconjunctival injection with 40 mg triamcinolone acetonide, an intravitreal injection with 1.25 mg bevacizumab, or a combination of both. The main outcomes were the difference in central subfield mean macular thickness, corrected distance visual acuity, and the incidence of CME and clinically significant macular edema within 6 and 12 weeks postoperatively. Results : The study comprised 213 patients. At 6 and 12 weeks postoperatively, the central subfield mean macular thickness was 12.3 μm and 9.7 μm lower, respectively, in patients who received subconjunctival triamcinolone acetonide than patients who did not ( P = .007 and P = .014, respectively). No patient who received subconjunctival triamcinolone acetonide developed CME. Intravitreal bevacizumab had no significant effect on macular thickness. Conclusions : Diabetic patients who received a subconjunctival injection with triamcinolone acetonide at the end of cataract surgery had a lower macular thickness and macular volume at 6 and 12 weeks postoperatively than patients who did not. Intravitreal bevacizumab had no significant effect.