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¹Uludağ Üniversitesi Tıp Fak., Göz Hast. A.D., Bursa, Yrd. Doç. Dr.
²Uludağ Üniversitesi Tıp Fak., Göz Hast. A.D., Bursa, Prof. Dr. Purpose: To evaluate the efficacy and reliability of cataract surgery with intravitreal triamcinolone injection in patients with cataract and coexisting clinically significant diabetic macular edema.
Materials and Methods: Seventeen eyes of 14 patients with diabetic macular edema and cataract not obscuring the fundus evaluation were recruited. Ten patients underwent phacoemulsification and 8 eyes underwent mini-nuc cataract surgery. All the patients received an intravitreal injection of 4 mg of triamcinolone acetonide at the end of the surgery. Patients were evaluated preoperatively, and at 1 day, and 1, 3, and 6 months postoperatively with best-corrected visual acuity and intraocular pressure measurement, fundoscopy, and fluorescein fundus angiography. Complications and the patients who needed laser photocoagulation were recorded.
Results: All the patients were followed-up for 6 months. Thirteen eyes (76%) showed 2 lines or more improvement of visual acuity. The mean visual acuity improved by 2.9, 3.8, and 3.4 lines at 1, 3, and 6 months follow-up, respectively (p<0.01 for all control points). The macular edema completely resolved in 12 eyes (71%) and decreased in 5 eyes (29%). Four eyes showed recurrence of the macular edema during the follow-up. Two of these eyes underwent macular, and the other 2 eyes underwent combined macular and panretinal laser photocoagulation. Intraocular pressure exceeded 21 mmHg in 4 eyes (24%), which were controlled by topical medication.
Conclusion: Combined cataract surgery and intravitreal triamcinolone may be an effective and reliable method in preventing deterioration of macular edema in cases of diabetic macular edema and coexisting cataract not obscuring the fundus evaluation. Keywords : Cataract surgery, diabetic macular edema, intravitreal triamcinolone