Comparison Of The Effects Of Phacoemulsification And Dexamethasone Implantation In The Same Session With Other Phakic Conditions

OBJECTIVES: To evaluate anatomical and functional results such as best corrected visual acuity (BCVA), central macular thickness (CMT), and intraocular pressure (IOP) in patients who received intravitreal dexamethasone (DEX) implant for diabetic macular edema (DME), and to compare the efficacy according to patients’ lens status and concurrent phacoemulsification surgery.
METHODS: A total of 70 eyes of 55 patients with DME who received intravitreal DEX implantation were included in this retrospective study. Patients who received intravitreal DEX implantation were divided into three groups phaco-DEX (group 1), pseudophakic (group 2), and phakic (group 3). The best corrected visual acuity (BCVA), central macular thickness (CMT), and intraocular pressure (IOP) changes were compared between the three groups.
RESULTS: One month after the intravitreal DEX implant, BCVA improved in all three groups. (p = 0.001, p = 0.01 and p = 0.009 respectively). There was a decrease in CMT at the end of 1st and 4th months in all three groups compared to the preoperative measurements (p = 0.005, p <0.001, p <0.001 respectively). While IOP was increased in group 2 and group 3, no IOP increase was observed in group 1. (p = 0.41, p = 0.01 and p = 0.01, respectively).
DISCUSSION AND CONCLUSION: Combining intravitreal DEX implantation with phacoemulsification surgery seems to be an effective and reliable method in patients with DME accompanied with cataract. The IOP elevation in follow-up visits of phakic and pseudophakic patients after intravitreal DEX implantation was not observed in the Phaco-DEX group.