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A Meta-Analysis

Feng, Yifan MD, PhD*,†; Zhu, Senmiao MD*,‡; Skiadaresi, Eirini MD, MSc, FEBO§; McAlinden, Colm MD, MB, BCh, BSc (Hons), MSc, PhD, MRCOphth*,§; Tu, Ruixue MD*,‡; Gao, Rongrong MD, MS*; Stephens, Jeffrey W. BSc, MB, BS, PhD, FRCP, FAcadMEd; Wang, Qinmei MD*,†; Huang, Jinhai MD, MS, PhD*,†

doi: 10.1097/IAE.0000000000002221
Original Study: PDF Only

Purpose: To evaluate the clinical effectiveness of intravitreal bevacizumab (IVB) injection combined with cataract surgery in the treatment of patients with cataract and coexisting diabetic retinopathy (DR).

Methods: Pertinent comparative studies were identified through systemic searches of PubMed, EMBASE, and the Cochrane Controlled Trials Register up to March 1, 2016. Outcome measures included corrected distance vision acuity, central macular thickness, and progression of DR and maculopathy. A meta-analysis was performed using RevMan (Cochrane Collaboration, Oxford, United Kingdom).

Results: Six studies describing a total of 283 eyes were identified. The meta-analysis results showed that corrected distance vision acuity measured at 1 month and 3 months after cataract surgery was significantly better in the IVB groups than in the control groups (P < 0.00001 and P = 0.01), whereas the corrected distance vision acuity at 6 months did not vary significantly between the 2 groups (P = 0.24). Similarly, the central macular thickness at 1, 3, and 6 months after surgery was significantly thinner in the IVB groups than in the control groups (P = 0.01, P = 0.0004, and P = 0.01, respectively). At 6 months, the progression of postoperative DR and maculopathy occurred more frequently in the control group than in the IVB group (P = 0.0001 and P < 0.0001, respectively).

Conclusion: Our meta-analysis indicates that cataract surgery combined with IVB seems to be an effective treatment in patients with coexisting DR in the short term (up to 6 months). More randomized, prospective, and large-sample–sized trials are needed to evaluate the long-term effects of IVB at the time of cataract surgery in patients with DR.

Cataract surgery combined with intravitreal bevacizumab for patients with diabetic retinopathy seems to be an effective and safe treatment in the short term at least. High-quality studies are still needed to evaluate the long-term effects of this combined surgery.

*School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China;

Department of Ophthalmology, Zhongshan Hospital, Fudan University, Shanghai, China;

Key Laboratory of Vision Science, Ministry of Health P.R. China, Wenzhou, Zhejiang, China;

§Department of Ophthalmology, Glangwili Hospital, Hywel Dda University Health Board, Carmarthen, United Kingdom; and

Institute of Life Sciences, School of Medicine, Swansea University, Swansea, United Kingdom.

Reprint requests: Jinhai Huang, MD, MS, PhD, Eye Hospital of Wenzhou Medical University, 270 West Xueyuan Road, Wenzhou 325027, Zhejiang, China; e-mail:

Supported in part by Health Bureau of Zhejiang Province (2016RCB013); Science and Technology Planning Project of Zhejiang Province (2016C33082); Zhejiang Provincial & Ministry of Health Research Fund For Medical Sciences (WKJ-ZJ-1530); Scientific Research Fund of Zhejiang Provincial Kangenbei (2015ZHA-KEB206); and National Science and Technology Major Project (2014ZX09303301).

None of the authors has any financial/conflicting interests to disclose.

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© 2019 by Ophthalmic Communications Society, Inc.