lINTRAOPERATIVE INTRAVITREAL TRIAMCINOLONE ACETONIDE DURING CATARACT SURGERY FOR THE PROPHYLAXIS AND MANAGEMENT OF POSTOPERATIVE DIABETIC MACULAR EDEMA
Keywords:Phacoemulsification, diabetic macular edema, Intravitreal Triamcinolone injection
AbstractCataract extraction in diabetic patients is commonly indicated, both for visual rehabilitation and for improved visualization of the fundus. Unfortunately the visual prognosis for diabetic patients undergoing cataract surgery is guarded, mainly because of the risk for worsening retinopathy levels and exacerbation of macular edema. The Aim of this study is to evaluate the efficacy of intravitreal Triamcinolone acetonide injected during cataract surgery in the prophylaxis and management of postoperative macular edema following uneventful cataract surgery in diabetics. The study included 2 groups, Group A included 15 patients divided into 2 subgroups 1)-Diabetic patients without any excising macular oedema., 2)-Diabetic patients with pre-existing macular edema. Patients in Group A were subjected to phacoemulsification with Posterior chamber intraocular lens implantation. Subjects and methods: Group B included 15 diabetic patients with or without preoperatively existing macular edema including patients with previous macular laser treatment with visually significant cataract. Patients were subjected to Phacoemulsification with PCIOL implantation and Intravitreal triamcinolone injection (dose of 8 mg in 0.2 ml will be injected slowly through the inferior pars plana). Results: The results of this study showed that phacoemulsification with intravitreal TA in patients with CSME appears to be a safe intervention to avoid the postoperative exacerbation of the edema in patients with dense cataract precluding macular laser treatment. TA may serve as mean to control postoperative inflammation and prevent exacerbation of the macular edema. Postoperative laser treatment may be needed in some cases to augment the effect of intravitreal TA.
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