Purpose:

To evaluate the role of intravitreal ranibizumab, injected at the time of cataract surgery on the progression of postoperative diabetic macula edema (PME) in non-proliferative diabetic retinopathy (NPDR).

Setting:

Multi-center, prospective randomized study.

Methods:

80 Patients with NPDR and cataract were randomized to 40 only cataract surgery (Sham group) or 40-cataract surgery plus intraoperative ranibizumab injection (ranibizumab injection group). PME was assessed at 1, 3 and 6-month follow-up with optical coherence tomography (OCT). Best-corrected visual acuity (BCVA) was assessed at 1, 3 and 6-month follow-up. We defined the clinically meaningful PME as an increase of CFT >30% from preoperative baseline by OCT. Postoperative CFT and BCVA were compared between sham and ranibizumab injection group during 6 month.

Results:

71 patients have finished this randomized study. At 1 month, mean preoperative CFT was 253um in ranibizumab injection group, and 250um in sham injection group. PME occurred in 4(10.5%) of 38 eyes in ranibizumab injection group and 11(33.3%) of 31 eyes in sham injection group. (p=0.019) At 6-month follow-up, ranibizumab injection group showed better visual acuity than sham injection group. (p=0.031) There was one case of mild postoperative vitreous hemorrhage in ranibizumab injection group.

Conclusion:

In patients with NPDR and cataract, intravitreal ranibizumab injection at the time of cataract surgery could prevent the clinically meaningful PME at 1 month, and finally showed better visual acuity at 6-month follow-up.