Sanjeeb Bhandari, Vuong Nguyen, Mark Gillies
Purpose: To evaluate outcomes and factors predict- ing visual acuity (VA) change after cataract surgery in eyes treated with intravitreal injections for dia- betic macular oedema (DME).
Methods: Eyes receiving cataract surgery that were tracked by the diabetic retinopathy module of the Fight Retinal Blindness (FRB)! Project database were analyzed. These eyes were compared to a cohort of phakic eyes from the database matched 1:1 on the following characteristics: treatment duration before cataract surgery, prior treatment status, year of starting treatment with intravitreal injections, and VA, age & central subﬁeld thickness (CST) at baseline.
Results: Cataract surgery was performed on
108 eyes. Mean VA improved by 8.7 letters (P < 0.001)); 25.1% gained≥15 letters while 0.9% lost≥15 letters. Mean CST and number of injections 6 months before and after surgery were similar (354.4 vs 375.9; P = 0.11 & 2.9 vs 2.7; P = 0.3). CST decreased from baseline in both groups, but eyes with cataract had thicker foveas and were receiving more injec- tions than their controls both before and after sur- gery. Younger patients were more likely to gain vision (P = 0.003) and eyes with lower visual acuity were likely to gain ≥ 15 letters (P < 0.001). Eyes with centre-involving macular oedema prior to sur- gery were likely to lose vision (P = 0.028). We found no evidence that an injection of a VEGF inhibitor or steroid within 4 weeks before surgery was beneﬁcial. Conclusion: We found reasonably good visual and anatomic outcomes after removal of cataracts from eyes with DME. Further studies are warranted to determine whether eyes that are developing cataract are more likely to develop DME.