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Cancer treatment controls macular edema related to diabetes and to cataract surgery
Date:7/31/2009

ll cataract surgery patients develop CME, in which the macula swells as fluid-filled cysts form. Usually the condition resolves without treatment and causes no permanent vision loss, but in a small percentage of patients vision remains worse than 20/40 and treatment is needed. Standard treatments include steroids, non-steroidal anti-inflammatories (NSAIDs), other medications, or surgery.

The researchers reviewed the records of 31 patients (36 eyes) who were treated with at least one IVB injection and followed for 12 months between 2005 and 2007. At the study's outset the mean best-corrected visual acuity was 20/200, and at 12 months the mean was 20/80. Most eyes (72.2 percent) improved and the rest remained stable (27.8 percent). Macular thickness also decreased in most eyes. Patients who received two or more injections were significantly more likely to improve. No adverse systemic or vision side effects or outcomes were reported.

"Large, randomized controlled clinical trials are needed to confirm IVB's efficacy and safety in treating these conditions," Dr. Arevalo said. "The results for DMME are very promising and suggest that combining anti-VEGF treatment with laser therapy may prove useful." He added, "Also, once further study is completed, unresolved CME post-cataract surgery should be considered for inclusion as an indication for use of IVB." "

Extra Precautions Needed with Cataract Surgery for DR Patients

Before 1996, retinopathy often developed or progressed rapidly in diabetic patients following cataract surgery. In the past decade the less-invasive phacoemulsification method has reduced cataract surgery complications in general, but the impact on diabetic retinopathy has been unclear. A clinic-based cohort study (2004 to 2006) led by Jie Jin Wang, MMed, PhD, at the Centre for Vision Research, University of Sydney, Australia, followed 169 diabetic patients aged 65 years and older for 12 months post-cataract surgery. Forty-f
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Contact: Mary Wade
mwade@aao.org
415-561-8534
American Academy of Ophthalmology
Source:Eurekalert

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