دورية أكاديمية
Pre-operative versus post-operative intravitreal aflibercept injection for management of DME in patients undergoing cataract surgery.
العنوان: | Pre-operative versus post-operative intravitreal aflibercept injection for management of DME in patients undergoing cataract surgery. |
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المؤلفون: | Khattab AM; Department of Ophthalmology, Faculty of Medicine, Mansoura University, Mansoura, Egypt.; Department of Ophthalmology, Al-Hadi Clinic, Jabriya, Kuwait., Hagras SM; Department of Ophthalmology, Faculty of Medicine, Mansoura University, Mansoura, Egypt. shereinhagras@gmail.com., Lotfy NM; Department of Ophthalmology, Faculty of Medicine, Cairo University, Cairo, Egypt. |
المصدر: | Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie [Graefes Arch Clin Exp Ophthalmol] 2023 Nov; Vol. 261 (11), pp. 3223-3229. Date of Electronic Publication: 2023 Jun 17. |
نوع المنشور: | Journal Article |
اللغة: | English |
بيانات الدورية: | Publisher: Springer-Verlag Country of Publication: Germany NLM ID: 8205248 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1435-702X (Electronic) Linking ISSN: 0721832X NLM ISO Abbreviation: Graefes Arch Clin Exp Ophthalmol Subsets: MEDLINE |
أسماء مطبوعة: | Original Publication: Berlin ; New York : Springer-Verlag, c1982- |
مستخلص: | Aim: The aim of this paper is to investigate the need of deferring cataract surgery until treating the co-existing diabetic macular edema (DME) using intravitreal (IVI) anti-vascular endothelial growth factor (anti-VEGF). Methods: A prospective randomized interventional study included diabetic patients with visually significant cataract and DME. Patients were divided into 2 groups. Group A received three preoperative intravitreal (IVI) aflibercept injections with a monthly interval; the third injection was given intra-operatively. Group B received a single intra-operative injection, and two post-operative injections with a monthly interval. The primary outcome measure was the change in central macular thickness (CMT) at 1st and 6th month post-operative. The secondary outcome measures were best corrected visual acuity (BCVA) at same points and any documented adverse effects. Results: Forty patients were enrolled in the study, 20 patients in each group. Means of CMT at 1 month post-operatively were significantly higher in group B than group A but no statistical difference at 6 months. There was no statistical difference between the 2 groups regarding BCVA at 1 or 6 months post-operatively. Compared with the baseline values, BCVA and CMT improved significantly after 1 and 6 months within both groups. Conclusion: IVI of aflibercept given before cataract surgeries does not seem to have superior effect over postoperative injections in either macular thickness or visual outcomes. Hence, preoperative controlling of DME might not be mandatory in patients undergoing cataract surgery. Clinical Trial Registration: The study is registered in clinical trial. Gov (NCT05731089). (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.) |
References: | Kim SJ, Equi R, Bressler NM (2007) Analysis of macular edema after cataract surgery in patients with diabetes using optical coherence tomography. Ophthalmology 114(5):881–889. (PMID: 10.1016/j.ophtha.2006.08.05317275910) Meyer CH (2007) Current treatment approaches in diabetic macular edema. Ophthalmologica 221(2):118–131. (PMID: 10.1159/00009825717380066) Patel JI, Hykin PG, Cree IA (2006) Diabetic cataract removal: postoperative progression of maculopathy–growth factor and clinical analysis. Br J Ophthalmol 90(6):697–701. (PMID: 10.1136/bjo.2005.087403165404891860210) Boscia F, Giancipoli E, D’Amico Ricci G, Pinna A (2017) Management of macular oedema in diabetic patients undergoing cataract surgery. Curr Opin Ophthalmol 28(1):23–28. (PMID: 10.1097/ICU.000000000000032827661663) Steinle NC, Lampen SIR, Wykoff CC (2018) The intersection of diabetes mellitus and cataract surgery: current state of management. Ophthalmol Retina 2(2):83–85. (PMID: 10.1016/j.oret.2017.11.00731047349) Avitabile T, Azzolini C, Bandello F, Boscia F, De Falco S, Fornasari D et al (2017) Aflibercept in the treatment of diabetic macular edema: a review and consensus paper. Eur J Ophthalmol 27(6):627–639. (PMID: 10.5301/ejo.500105329077188) Pham B, Thomas SM, Lillie E, Lee T, Hamid J, Richter T et al (2019) Anti-vascular endothelial growth factor treatment for retinal conditions: a systematic review and meta-analysis. BMJ Open 9(5):e022031. (PMID: 10.1136/bmjopen-2018-022031311425166549720) Moshfeghi AA, Shapiro H, Lemmon LA, Gune S (2018) Impact of cataract surgery during treatment with ranibizumab in patients with diabetic macular edema. Ophthalmol Retina 2(2):86–90. (PMID: 10.1016/j.oret.2017.05.00331047350) Arima M, Nakao S, Yamaguchi M, Feng H, Fujii Y, Shibata K et al (2020) Claudin-5 redistribution induced by inflammation leads to anti-VEGF-resistant diabetic macular edema. Diabetes 69(5):981–999. https://doi.org/10.2337/db19-1121. (PMID: 10.2337/db19-112132139595) Zhao LQ, Cheng JW (2019) A systematic review and meta-analysis of clinical outcomes of intravitreal anti-VEGF agent treatment immediately after cataract surgery for patients with diabetic retinopathy. J Ophthalmol 16(2019):2648267. https://doi.org/10.1155/2019/2648267. (PMID: 10.1155/2019/2648267) Yumusak E, Ornek K (2016) Comparison of perioperative ranibizumab injections for diabetic macular edema in patients undergoing cataract surgery. J Ophthalmol 2016:7945619. (PMID: 10.1155/2016/7945619274937954963569) Cheema RA, Al-Mubarak MM, Amin YM, Cheema MA (2009) Role of combined cataract surgery and intravitreal bevacizumab injection in preventing progression of diabetic retinopathy: prospective randomized study. J Cataract Refract Surg 35(1):8–25. (PMID: 10.1016/j.jcrs.2008.09.019) Chae JB, Joe SG, Yang SJ, Lee JY, Sung KR, Kim JY et al (2014) Effect of combined cataract surgery and ranibizumab injection in postoperative macular edema in non-proliferative diabetic retinopathy. Retina 34(1):149–156. (PMID: 10.1097/IAE.0b013e3182979b9e23807186) Yu SY, Nam DH, Lee DY (2018) Changes in aqueous concentrations of various cytokines after intravitreal bevacizumab and subtenon triamcinolone injection for diabetic macular edema. Graefe’s Arch Clin Exp Ophthalmol 256(1):39–47. (PMID: 10.1007/s00417-017-3819-2) Rauen PI, Ribeiro JA, Almeida FP, Scott IU, Messias A, Jorge R (2012) Intravitreal injection of ranibizumab during cataract surgery in patients with diabetic macular edema. Retina 32(9):1799–1803. (PMID: 10.1097/IAE.0b013e31824bebb822495327) Feng Y, Zhu S, Skiadaresi E, McAlinden C, Tu R, Gao R et al (2018) Phacoemulsification cataract surgery with prophylactic intravitreal bevacizumab for patients with coexisting diabetic retinopathy. Retina 39(9):1720–1731. (PMID: 10.1097/IAE.0000000000002221) Stewart MW (2011) What are the half-lives of ranibizumab and aflibercept (Trap-eyeVEGF) in human eyes? Calculations with a mathematical model. Eye Reports 1:5. (PMID: 10.4081/eye.2011.e5) Niwa Y, Kakinoki M, Sawada T, Wang X, Ohji M (2015) Ranibizumab and aflibercept: intraocular pharmacokinetics and their effects on aqueous VEGF level in vitrectomized and non-vitrectomized macaque eyes. Invest Ophthalmol Vis Sci 56(11):6501–6505. (PMID: 10.1167/iovs.15-1727926447985) Stratton IM, Scanlon PH, Talks JS, Chakravarthy U, Mukherjee R, Ghanchi F et al (2019) Aflibercept in the real world – are the visual outcomes worse in patients with diabetic macular edema who have had a cataract operation? Invest Ophthalmol Vis Sci 60(9):2637. Starr MR, Mahr MA, Smith WM, Iezzi R, Barkmeier AJ, Bakri SJ (2021) Outcomes of patients with active diabetic macular edema at the time of cataract surgery managed with intravitreal anti-VEGF injections. Am J Ophth 229:194–199. (PMID: 10.1016/j.ajo.2021.04.00233852907) |
فهرسة مساهمة: | Keywords: Aflibercept; Cataract; Diabetic macular edema; Diabetic retinopathy |
سلسلة جزيئية: | ClinicalTrials.gov NCT05731089 |
تواريخ الأحداث: | Date Created: 20230617 Latest Revision: 20231019 |
رمز التحديث: | 20231019 |
DOI: | 10.1007/s00417-023-06138-6 |
PMID: | 37329361 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1435-702X |
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DOI: | 10.1007/s00417-023-06138-6 |