TY - JOUR
T1 - Intravitreal dexamethasone implant one month before versus concomitant with cataract surgery in patients with diabetic macular oedema
T2 - the dexcat study
AU - Fallico, Matteo
AU - Avitabile, Teresio
AU - Castellino, Niccolò
AU - Longo, Antonio
AU - Russo, Andrea
AU - Bonfiglio, Vincenza
AU - Parisi, Francesca
AU - Furino, Claudio
AU - Panozzo, Giacomo
AU - Scorcia, Vincenzo
AU - Carnevali, Adriano
AU - Bandello, Francesco
AU - Parodi, Maurizio Battaglia
AU - Cennamo, Gilda
AU - Cillino, Salvatore
AU - Vadalà, Maria
AU - Sunseri Trapani, Valentina
AU - Cagini, Carlo
AU - Fiore, Tito
AU - Lupidi, Marco
AU - Parravano, Mariacristina
AU - Varano, Monica
AU - Giorno, Paola
AU - Boscia, Francesco
AU - Giancipoli, Ermete
AU - Eandi, Chiara
AU - Le Mer, Yannick
AU - Reibaldi, Michele
N1 - Publisher Copyright:
© 2020 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/6/26
Y1 - 2020/6/26
N2 - Purpose: To report clinical outcomes of two different timings of intravitreal dexamethasone (DEX) implant administration for prevention of diabetic macular oedema (DME) worsening following cataract surgery. Methods: This multicentre, retrospective study included patients with DME who received an intravitreal DEX implant 1 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 coherence tomography (OCT) imaging at baseline (cataract surgery) and throughout follow-up. Anatomical improvement was considered to be a decrease in OCT central subfield (CSF) thickness ≥20% compared to baseline. The primary outcomes were 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 ‘concomitant treatments’ group. At 3 months, a reduction of CSF thickness ≥ 20% was found in 7.3% of eyes in the ‘precataract DEX 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 in both 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.
AB - Purpose: To report clinical outcomes of two different timings of intravitreal dexamethasone (DEX) implant administration for prevention of diabetic macular oedema (DME) worsening following cataract surgery. Methods: This multicentre, retrospective study included patients with DME who received an intravitreal DEX implant 1 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 coherence tomography (OCT) imaging at baseline (cataract surgery) and throughout follow-up. Anatomical improvement was considered to be a decrease in OCT central subfield (CSF) thickness ≥20% compared to baseline. The primary outcomes were 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 ‘concomitant treatments’ group. At 3 months, a reduction of CSF thickness ≥ 20% was found in 7.3% of eyes in the ‘precataract DEX 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 in both 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.
KW - cataract surgery
KW - dexamethasone implant
KW - diabetes
KW - diabetic macular oedema
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U2 - 10.1111/aos.14516
DO - 10.1111/aos.14516
M3 - Article
C2 - 32588978
AN - SCOPUS:85087125759
JO - Acta Ophthalmologica
JF - Acta Ophthalmologica
SN - 1755-375X
ER -