Dexamethasone intravitreal implant along with femtosecond laser assisted cataract surgery in patients with diabetic macular edema and cataract

Purpose To assess the safety and efficacy of intraoperative dexamethasone intravitreal (DEX) implant in patients with diabetic macular edema (DME) undergoing femtosecond laser assisted cataract surgery (FLACS). Methods In this single-center retrospective study, the charts of patients who underwent combined FLACS and DEX implant in the previous three months were reviewed. Primary outcome measures were ocular complications; secondary outcome measures were the change of best-corrected visual acuity (BCVA) and central retinal thickness (CRT). Results 20 eyes of 20 patients were included. None developed intraoperative or postoperative complications. Mean BCVA was 20/120 (logMAR, 0.78 +/- 0.31) at baseline and improved significantly to 20/63 (logMAR, 0.52 +/- 0.24; p = 0.01), 20/58 (LogMAR, 0.48 +/- 0.28; p < 0.001) and to 20/58 (LogMAR, 0.48 +/- 0.31; p < 0.001) at month 1,2 and 3, respectively. A mean improvement of 0.30 LogMAR was recorded at month 1 and 3. Mean CRT decreased significantly from 416.6 +/- 76.1 mu m at baseline to 322.4 +/- 46.4 mu m (p < 0.001), to 300.7 +/- 29.7 mu m (p < 0.001), and to 319.8 +/- 54.7 mu m (p < 0.001) at month 1,2 and 3, respectively. Comparing to the 1-month follow-up, the largest mean reduction in CRT (112.4 +/- 68.9 mu m) was observed at month 2 (p = 0.001). Fourteen patients (70%) had an improvement of CRT over the first 2 months followed by a recurrence of edema at month 3. Conclusion DEX implant following FLACS seems to be a safe and effective approach for patients with coexisting cataract and DME.