Triamcinolone, bevacizumab yield similar VA outcomes in cataract patients with DME
SAN DIEGO — No significant difference in best corrected visual acuity was seen when patients with diabetic macular edema at the time of cataract surgery were given either triamcinolone or bevacizumab, according to a speaker here.
“The poorest visual outcomes are seen in those with diabetic macular edema at the time of surgery,” said Salmaan Al-Qureshi, MBBS, FRANZCO, who presented 6-month results from the DiMECAT trial at the American Society of Retina Specialists annual meeting. “Despite the advances in treatment, there is very little evidence regarding the use of anti-VEGF or triamcinolone in cataract surgery.”
Thirty patients have reached the 6-month follow-up in the prospective, masked clinical trial of 46 patients with diabetic macular edema at the time of cataract surgery. Patients were randomly assigned to receive either 4 mg triamcinolone (Triesence, Alcon) or 1.25 mg bevacizumab (Avastin, Genentech).
Al-Qureshi and colleagues found both groups had an overall increase in BCVA, with the triamcinolone group trending toward a greater gain and better central macular thickness.
There was a statistically significant difference in the number of retreatments between the two groups, with the triamcinolone group needing a mean of 0.19 retreatments and the bevacizumab group requiring a mean of 1.93 retreatments at 6 months.
“There are few studies of the outcome of cataract surgery with either anti-VEGF or [intravitreal triamcinolone] in patients with preexisting DME,” al-Qureshi said.
Reduction in central macular thickness was sustained in the triamcinolone group, whereas central macular thickness tended to increase in the bevacizumab group.
Disclosure: Al-Qureshi has no relevant financial disclosures.