Management of macular oedema in diabetic patients undergoing cataract surgery

Curr Opin Ophthalmol. 2017 Jan;28(1):23-28. doi: 10.1097/ICU.0000000000000328.

Abstract

Purpose of review: The 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 findings: Topical 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.

Conclusion: All 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.

Publication types

  • Review

MeSH terms

  • 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*

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Ophthalmic Solutions