Cataract Surgery Outcomes Unaffected by Intravitreal Aflibercept for Diabetic Macular Edema

Intravitreal injection (IVI) of aflibercept for treating diabetic macular edema during cataract surgery does not appear to interfere with the surgery’s functional and tomographic parameters, according to findings published in Medicine.

“As a primary finding, this study revealed that in patients with diabetic macular edema, aflibercept IVI administered during cataract surgery was not associated with a significant net change in central subfield thickness and visual acuity at 3 months compared with only cataract surgery,” wrote researchers. “It [is] suggested that the improvement in visual acuity was mainly due to cataract removal.”

The observational study included 106 patients older than 40 years with type 2 diabetes mellitus and diabetic macular edema who received cataract surgery at a Taiwan hospital between January 1, 2016, and October 31, 2020. Patients were categorized into 2 groups based on whether they received aflibercept IVI or not during cataract surgery.

According to study authors, there were no differences in net change in central subfield thickness and log MAR visual acuity between groups.

“Gender, glycated hemoglobin level, aflibercept IVI during cataract surgery, and baseline central subfield thickness did not interfere with the morphological and functional outcomes of diabetic macular edema in cataract surgery,” wrote researchers.

However, age, baseline diabetic retinopathy staging, and baseline visual acuity did appear to affect outcomes in patients with diabetic macular edema. Older age was associated with a higher net change in log MAR visual acuity, reported researchers. Proliferative diabetic retinopathy was associated with more net change in central subfield thickness and log MAR visual acuity. Finally, greater log MAR visual acuity at baseline was linked with less net change in log MAR visual acuity.

“Identifying these factors of diabetic macular edema preoperatively may be an important consideration in preventing it from progressing and for improving the overall visual prognosis,” advised researchers.

Reference:
Yen CY, Yen JC, Chen CC, Hu HY, Cheng FS, Tseng PC. Therapeutic effect of cataract surgery with simultaneous intravitreal injection of aflibercept on diabetic macular edema: an observational study. Medicine. 2022;101(33):e30115. doi:10.1097/MD.0000000000030115