Intravitreal dexamethasone implant one month before versus concomitant with cataract surgery in patients with diabetic macular edema: the DEXCAT study.

Salvatore Cillino, Vincenza Maria Elena Bonfiglio, Maria Vadala', Vincenzo Scorcia, Paola Giorno, Andrea Russo, Marco Lupidi, Gilda Cennamo, Giacomo Panozzo, Niccolò Castellino, Adriano Carnevali, Ermete Giancipoli, Maurizio Battaglia Parodi, Francesca Parisi, Matteo Fallico, Claudio Furino, Vincenza Bonfiglio, Michele Reibaldi, Mariacristina Parravano, Chiara EandiCarlo Cagini, Monica Varano, Francesco Boscia, Teresio Avitabile, Tito Fiore, Yannick Le Mer, Francesco Bandello, Antonio Longo, Valentina Sunseri Trapani

Risultato della ricerca: Articlepeer review

Abstract

Purpose: To report clinical outcomes of two different timings of intravitreal dexamethasone (DEX) implant administrationfor prevention of diabetic macular oedema (DME) worsening following cataract surgery.Methods: This multicentre, retrospective study included patients with DME who received an intravitreal DEX implant1 month before cataract surgery, ‘precataract DEX’ group, or at the time of cataract surgery, ‘concomitant treatments’group. Inclusion criteria were a follow-up ≥3 months and ophthalmological examination with optical coherencetomography (OCT) imaging at baseline (cataract surgery) and throughout follow-up. Anatomical improvement wasconsidered to be a decrease in OCT central subfield (CSF) thickness ≥20% compared to baseline. The primary outcomeswere anatomical and functional results at 3 months.Results: Two hundred twenty-one patients were included: 136 in the ‘precataract DEX’ group and 85 in the ‘concomitanttreatments’ group. At 3 months, a reduction of CSF thickness ≥ 20%was found in 7.3%of eyes in the ‘precataractDEX group’and in 83.7% of eyes in the ‘concomitant treatments’ group (p < 0.001), with mean CSF thickness lower in the latter group(371 52 μm versus 325 57 μm, p < 0.001). At 3 months, mean best-corrected visual acuity had improved from baseline inboth groups (p < 0.001), with no difference between groups (p = 0. 20). No serious systemic adverse events were reported.Conclusion: Both approaches prevented a worsening of DME, showing a comparable visual outcome. Dexamethasone(DEX) implant given at the same time as cataract surgery provided a better anatomical outcome.
Lingua originaleEnglish
Numero di pagine7
RivistaActa Ophthalmologica
Stato di pubblicazionePublished - 2020

All Science Journal Classification (ASJC) codes

  • Ophthalmology

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