Role of combined cataract surgery and intravitreal bevacizumab injection in preventing progression of diabetic retinopathy: Prospective randomized study
Received 1 April 2008; received in revised form 29 August 2008; accepted 5 September 2008.
Purpose
To evaluate the role of intravitreal bevacizumab, an anti-vascular endothelial growth factor agent, injected at the time of cataract surgery on the postoperative progression of diabetic retinopathy (DR) and diabetic maculopathy.
Setting
Tertiary-care eye specialty hospital, Dhahran, Kingdom of Saudi Arabia.
Methods
Patients were randomized to a standardized procedure of phacoemulsification with intraocular lens implantation alone (control group) or to receive 1.25 mg intravitreal bevacizumab at the end of surgery (intervention group). Diabetic retinopathy and maculopathy were assessed at each postoperative visit during a 6-month follow-up.
Results
Sixty-eight eyes (68 patients) with DR and cataract were recruited for this prospective study. Progression of DR occurred in 15 (45.45%) of 33 eyes in the control group and 4 (11.42%) of 35 eyes in the intervention group (P = .002) Progression of diabetic maculopathy occurred in 17 eyes (51.51%) in the control group and 2 eyes (5.71%) in the intervention group (P = .0001). There was no statistically significant difference in postoperative visual acuity between the 2 groups (P = .772). Two eyes in the control group and none in the intervention group progressed to neovascular glaucoma. The mean postoperative central macular thickness and mean macular thickness were not statistically significantly different between the 2 groups (P = .874 and .942, respectively).
Conclusion
Intravitreal administration of 1.25 mg bevacizumab at the time of cataract surgery was safe and effective in preventing the progression of DR and diabetic maculopathy in patients with cataract and DR.
From the Vitreo-Retinal Service (R.A. Cheema, Al-Mubarak, Amin), Dhahran Eye Specialist Hospital, Dhahran, Kingdom of Saudi Arabia, and Cardiff University School of Medicine (M.A. Cheema), Cardiff, United Kingdom
Corresponding author: Rizwan A. Cheema, FRCOphth, 29 Ffordd Cwellyn, Cardiff CF23 5NB, United Kingdom.
No author has a financial or proprietary interest in any material or method mentioned.
ABSTRACT