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ORIGINAL ARTICLE
Year : 2013  |  Volume : 106  |  Issue : 2  |  Page : 108-110

Two-step procedure for the management of clinically significant senile cataract combined with diabetic retinopathy


Department of Ophthalmology, Faculty of Medicine, Mansoura University, Mansoura, Egypt

Correspondence Address:
Mohamed A Gad
MD, Department of Ophthalmology, Faculty of Medicine, Mansoura University, Mansoura
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.7123/01.JEO.0000431548.45394.b3

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Aim of the work

The aim of this work was to evaluate the efficacy and safety of a two-step procedure in the management of visually significant senile cataract combined with diabetic retinopathy that required laser treatment.

Patients and methods

Patients with clinically significant senile cataract combined with diabetic retinopathy, either proliferative diabetic retinopathy or clinically significant macular edema, or both, underwent a two-step procedure. The first step was phacoemulsification and an intravitreal injection of bevacizumab. The second step, after 3 weeks, involved laser treatment of the retina, which included panretinal photocoagulation, grid pattern laser treatment, or both. Postoperative follow-up was carried out with a special focus on visual acuity expressed as log MAR and macular thickness measured by optical coharrent tomography at 1 week, 1 month, and 6 months after injection.

Results

Visual acuity improved from 1.12±0.115 to 0.18±0.580 1 week postoperatively in patients who underwent only panretinal photocoagulation whereas it improved from 1.77±0.115 to 0.30±0.120 in patients who underwent grid pattern laser treatment. visual acuity remained stable throughout the follow-up period. Macular thickness decreased from mean 465±90 to 255±30 μ 1 week postoperatively and reached 280±2 μm 6 month postoperatively. Five patients with rubeosis iridis showed regression of iris neovessel.

Conclusion

The two-step procedure is effective for the management of senile cataract combined with diabetic retinopathy.



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