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Management of macular oedema in diabetic patients undergoing cataract surgery

Boscia, Francesco; Giancipoli, Ermete; D’Amico Ricci, Giuseppe; Pinna, Antonio

Current Opinion in Ophthalmology: January 2017 - Volume 28 - Issue 1 - p 23–28
doi: 10.1097/ICU.0000000000000328
CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari
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Purpose of review The aim of this study was to describe all the treatment modalities used to prevent and manage macular oedema in diabetic patients undergoing cataract surgery.

Recent findings Topical NSAIDs have been proposed to be an effective strategy to prevent postsurgical macular oedema (PME) in diabetic patients. The prophylactic use of intravitreal antivascular endothelial growth factors (anti-VEGF) drugs and steroids in these patients, even if effective, brings some concerns with regard to possible side effects. By contrast, in patients with a diagnosis of diabetic macular oedema (DME) at the time of cataract surgery, intravitreal therapy, both with anti-VEGF drugs and steroids, appears to be the best approach in order to control PME and achieve a good visual outcome.

Conclusion All diabetic patients undergoing cataract surgery should be treated with topical NSAIDs to prevent PME. Intravitreal anti-VEGF drugs and steroids, combined with cataract surgery, should be reserved for patients with preexisting DME.

aDepartment of Surgical, Microsurgical and Medical Sciences, Ophthalmology Unit, University of Sassari

bAzienda Ospedaliero Universitaria di Sassari, Sassari, Italy

Correspondence to Prof. Francesco Boscia, Department of Surgical, Microsurgical, and Medical Sciences, Ophthalmology Unit, University of Sassari, Viale San Pietro 43 A, 07100 Sassari, Italy. Tel: +39 079 228251; fax: +39 079 228254; e-mail: francescoboscia@hotmail.com

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