Intravitreal dexamethasone implant one month before versus concomitant with cataract surgery in patients with diabetic macular oedema: the dexcat study

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

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish
JournalActa Ophthalmologica
DOIs
Publication statusE-pub ahead of print - Jun 26 2020

Keywords

  • cataract surgery
  • dexamethasone implant
  • diabetes
  • diabetic macular oedema

ASJC Scopus subject areas

  • Ophthalmology

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