Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2019, Vol. 33 ›› Issue (2): 99-104.doi: 10.6040/j.issn.1673-3770.0.2018.337

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Phacoemulsification combined with intravitreal ranibizumab or triamcinolone acetonide injection for the treatment of cataract accompanied by diabetic macular edema

LIU Jianbo1, ZHANG Huan2   

  1. Department of Ophthalmology, Affiliated Hospital of Weifang Medical University, Weifang 261031, Shandong, China
  • Published:2019-03-28

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Abstract: Objective To investigate the efficacy and safety of phacoemulsification combined with intravitreal ranibizumab or triamcinolone acetonide injection for treating patients with cataract accompanied by diabetic macular edema(DME). Methods In this case-control study, 66 patients(78 eyes)with cataract complicated by DME were randomly divided into three groups. The control group was treated with phacoemulsification and intraocular lens implantation. The IVR group was treated with cataract surgery and intravitreal ranibizumab injection. The IVTA group was treated with cataract surgery and intravitreal triamcinolone acetonide injection. The differences in best corrected visual acuity(BCVA), macular center retinal thickness(CRT), and intraocular pressure were compared among the three groups preoperatively and 1 week, 1 month, 3 months, and 6 months postoperatively. Results There were no significant differences in sex, age, duration of DM, preoperative BCVA(LogMAR), CRT, and intraocular pressure among the three groups(P>0.05). The overall trend(time)of BCVA(LogMAR)and CRT changes with time in the three groups before and after operation was significant(P<0.05). The trend(time*group)of BCVA(LogMAR)and CRT changes over time among the three groups was significant. The comprehensive differences(group)in BCVA(LogMAR)and CRT among the three groups were also significant regardless of time(P<0.05). Comparison of BCVA(LogMAR)and CRT among the three groups revealed a significant difference between the IVR group and control group, and between the IVTA group and control group(P<0.05). In addition, there was no significant difference between the IVR and IVTA groups in BCVA(LogMAR)and CRT(P>0.05). The overall trend(time)of intraocular pressure changes with time in the three groups was significant(P<0.001). The trend(time*group)of intraocular pressure changes over time among the three groups was significant(P<0.001). In 1 week and 1 month after operation, the intraocular pressure of the IVTA group increased, and there was significant difference between the IVTA group and the control group, and between the IVTA group and the IVR group(P<0.05). The comprehensive difference(group)in intraocular pressure among the three groups was not significant regardless of time(P=0.249). Conclusion Phacoemulsification combined with intravitreal ranibizumab or triamcinolone acetonide injection can improve BCVA and reduce macular edema in patients with cataract accompanied by DME. In addition, ranibizumab does not cause an increase in intraocular pressure and is safer and more reliable than triamcinolone acetonide.

Key words: Cataract, Diabetic retinopathy/complications, Macular edema, Antibodies, monoclonal, humanized, Glucocorticoids

CLC Number: 

  • R774.1
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