Management of macular oedema in diabetic patients undergoing cataract surgery

• Published in: Current opinion in ophthalmology Vol. 28; no. 1; pp. 23 - 28
• Main Authors: Boscia, Francesco, Giancipoli, Ermete, D’Amico Ricci, Giuseppe, Pinna, Antonio
• Format: Journal Article
• Language: English
• Published: United States Copyright Wolters Kluwer Health, Inc. All rights reserved 01-01-2017
• Subjects: Administration, Topical; Anti-Inflammatory Agents, Non-Steroidal - therapeutic use; Cataract Extraction; Diabetic Retinopathy - complications; Humans; Lens Implantation, Intraocular; Macular Edema - prevention & control; Ophthalmic Solutions; Postoperative Complications - prevention & control
• ISSN: 1040-8738; 1531-7021
• DOI: 10.1097/ICU.0000000000000328

PURPOSE OF REVIEWThe aim of this study was to describe all the treatment modalities used to prevent and manage macular oedema in diabetic patients undergoing cataract surgery.
RECENT FINDINGSTopical NSAIDs have been proposed to be an effective strategy to prevent postsurgical macular oedema (PME) in diabetic patients. The prophylactic use of intravitreal antivascular endothelial growth factors (anti-VEGF) drugs and steroids in these patients, even if effective, brings some concerns with regard to possible side effects. By contrast, in patients with a diagnosis of diabetic macular oedema (DME) at the time of cataract surgery, intravitreal therapy, both with anti-VEGF drugs and steroids, appears to be the best approach in order to control PME and achieve a good visual outcome.
CONCLUSIONAll diabetic patients undergoing cataract surgery should be treated with topical NSAIDs to prevent PME. Intravitreal anti-VEGF drugs and steroids, combined with cataract surgery, should be reserved for patients with preexisting DME.