Authors: Elmas Kubilhan, Bilen Özgür, Arsen Akýncý, Ersel Özkýlýç, Ali Altýnsoy, Ankara, Turkey

Advantages / Purpose:

To study the effect of Cataract Surgery with Bevacizumab alone and Combined with Intravitreal triamcinolone Injection on Progression of Diabetic Retinopathy. Setting: Kudret Eye Hospital, Ankara. Methods: Cataract surgery with phacoemulsification was performed in 52 eyes of 44 patients who had diabetic retinopathy. At first group 26 eyes enrolled to study. At the end of the surgery 1,25mg (0,05 ml) of bevacizumab was injected intravitreal at first group and 1,25mg (0,05 ml) of bevacizumab and 2 mg (0,05ml) triamcinolone was injected intravitreal at second group (26 eyes). All eyes had moderate to severe diabetic retinopathy findings including ischemic findings such as new vessels at disc and/or new vessels elsewhere or hypoxic areas in fundus fluorescein angiography. Outcomes were assessed 12 months postoperatively and included visual acuity (VA), progression of retinopathy and incidence of clinically significant macular oedema (CSME).

Results:

VA improved in 80% of cases at first group and 85% in second group, and was better than 0.4 in 55% of cases. Regression of retinopathy occurred in 81% of cases. Progression of retinopathy occurred in 19% of eyes. CSME occurred in 5 eyes (19,2%) at first group and 4 eyes (15,3%) in second group.

Conclusion:

Cataract surgery even performed with modern techniques may lead to progression of diabetic retinopathy due to surgical inflammatory reaction. If cataract surgery is combined with intravitreal bevacizumab and triamcinolone or bevacizumab alone in preproliferative or proliferative diabetic retinopathy, progression of the disease may decrease and success rate may increase. In comparison of both groups statistically no difference could be found in progression of retinopathy and CSME.