Do steroid injections during cataract surgery reduce complications for diabetic patients?

Posted by Medivizor on Oct 18, 2020 in Diabetes mellitus |

In a nutshell

This study looked at the benefit of injecting a steroid pellet into the eye during cataract surgery in patients with diabetic eye disease. They found that steroid injections reduced the risk of complications in patients with diabetic eye disease. 

Some background

Patients with diabetes often suffer from fluid in the back of the eye, known as diabetic macular edema (DME). This is a complication of diabetes. This can be worsened by cataract surgery. Injecting a steroid into the eye may help to reduce the risk of worsening DME. The steroid injection used is called dexamethasone (Ozurdex). It is injected into the jelly of the eye as a pellet. It then dissolves and slowly releases the steroid into the eye over several months.
A cataract is a condition that commonly develops in the eyes as people age. It is caused by a clouding of the normally clear lens in the eye and causes clouded vision. It often needs surgery for the replacement of the lens in the eye. Cataract surgery may be risky in patients with diabetes. It is unclear if injecting dexamethasone into the eye improves outcomes in diabetic patients undergoing cataract surgery.  

Methods & findings

This study looked at 24 eyes of 21 patients with DME. Each of these eyes underwent cataract surgery with the same surgeon. A dexamethasone injection was administered at the end of the operation. Patients were then followed for three months and had tests at 2 weeks, 1 month, and 3 months. These tests checked their vision and checked for any swelling of the retina which would indicate worsening of the DME. 
70.8% of the eyes achieved a reduction in DME of at least 20%. 66.6% achieved an improvement in vision equivalent to at least one line of letters on the vision chart after 1 month. At 3 months, 95.8% of the eyes had a stable vision.
16.7% of the eyes developed increased eye pressure due to the injection but this was controlled with eye drops. No other side effects were reported.

The bottom line

This study concluded that steroid injections at the time of cataract surgery may improve the outcome in patients with diabetic eye disease.

The fine print

This is a small study, based on medical records. Some information might have been incomplete. More research is needed.

Published By :
Advances in therapy

Original Title :
Combined Intravitreal Dexamethasone Implant and Cataract Surgery in Patients with Diabetic Retinopathy: Effect on Retinal Morphology and Function.

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