Study finds preoperative DME control unnecessary for cataract surgery

Intravitreal aflibercept injections administered before cataract surgery do not appear to have a superior effect on macular thickness or visual outcomes compared to post-operative injections in patients with co-existing diabetic macular edema (DME), according to a study, leading authors to suggest that preoperative control of DME might not be mandatory for patients undergoing cataract surgery.

In this prospective randomized interventional study, diabetic patients who had visually significant cataracts and DME were divided into 2 groups. Group A received 3 preoperative IVI aflibercept injections, with a monthly interval between injections. The third injection was administered intra-operatively. Group B received a single intra-operative injection and 2 post-operative injections, again with a monthly interval.

The primary outcome measure of the study was the change in central macular thickness (CMT) at the first and sixth month post-operative. The secondary outcome measures were the best-corrected visual acuity (BCVA) at the same time points, as well as any documented adverse effects.

A total of 40 patients, with 20 in each group, were enrolled in the study. The results showed that the mean CMT at 1 month post-operatively was significantly higher in Group B than in Group A. However, no statistical difference was observed between the groups at the 6-month mark.

Furthermore, there was no significant difference between the groups concerning BCVA at 1 or 6 months post-operatively. Both groups demonstrated significant improvement in BCVA and CMT compared to baseline values after 1 and 6 months.

Reference
Khattab AM, Hagras SM, Lotfy NM. Pre-operative versus post-operative intravitreal aflibercept injection for management of DME in patients undergoing cataract surgery. Graefes Arch Clin Exp Ophthalmol. 2023;doi: 10.1007/s00417-023-06138-6. Epub ahead of print. PMID: 37329361.