Purpose: To investigate macular thickness and visual acuity changes after 1 intravitreal injection of 0.5-mg ranibizumab during phacoemulsification cataract surgery in eyes with diabetic macular edema refractory to laser treatment.
Methods: Eleven eyes of 11 patients with diabetic macular edema refractory to modified Early Treatment Diabetic Retinopathy Study laser therapy received intravitreal during phacoemulsification cataract surgery. Comprehensive ophthalmic evaluation was performed preoperatively and at 1, 4, 8 ± 1, and 12 ± 2 weeks postoperatively. Main outcome measures included central subfield thickness and best-corrected Early Treatment Diabetic Retinopathy Study visual acuity.
Results: Eleven patients completed the 12-week study visit. Mean central subfield thickness (±SEM) was 399.82 ± 29.50 μm at baseline and did not change significantly at any postoperative study visit (P > 0.05). Mean (±SEM) best-corrected Early Treatment Diabetic Retinopathy Study visual acuity was 0.95 ± 0.13 logarithm of the minimum angle of resolution (20/200) at baseline and was significantly improved at Weeks 1 (0.38 ± 0.13), 4 (0.38 ± 0.11), 8 (0.35 ± 0.08), and 12 (0.46 ± 0.12) after treatment (P < 0.05).
Conclusion: In this case series of patients with diabetic macular edema refractory to laser therapy, intravitreal ranibizumab administered during cataract surgery was associated with no significant change in central subfield thickness postoperatively. Significant improvement in best-corrected Early Treatment Diabetic Retinopathy Study visual acuity was observed after treatment, likely because of cataract removal.
The present study reports the use of intravitreal ranibizumab during cataract surgery in patients with diabetic macular edema nonresponsive to laser therapy. In this case series, ranibizumab during cataract surgery was associated with no significant change in macular thickness postoperatively.
*Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
†Departments of Ophthalmology and Public Health Sciences, Penn State College of Medicine, Hershey, PA.
Reprint requests: Rodrigo Jorge, MD, Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Avenida Bandeirantes, 3900, Ribeirão Preto, São Paulo, 14049-900, Brazil; e-mail: firstname.lastname@example.org
The authors declare no conflict of interest.