The effect of intracameral dexamethasone used at the end of cataract surgery on macular edema in eyes with diabetic retinopathy

Yıl 2019, Cilt: 2 Sayı: 1, 18 - 23, 25.01.2019

Tevfik Oğurel , Kemal Örnek Reyhan Oğurel Zafer Onaran

https://doi.org/10.32322/jhsm.491881

Cited By: 1

Öz

Aim:
To evaluate the effect of intracameral dexamethasone
on diabetic macular edema injected at the end of cataract surgery in patients
with diabetic retinopathy.

Material
and Method: Thirty patients with diabetic retinopathy and
cataract were included in this study. All patients underwent a complete
ophthalmic examination which consisted best-corrected visual acuity (BCVA),
anterior segment evaluation with slit lamp microscopy, fundus examination with Goldman
three mirror lens,  intraocular pressure (IOP)
measurement with applanation tonometry before cataract surgery. Fundus fluorescein angiography (FFA) was taken
following each ocular examination. At the end of cataract surgery 0,1 cc
dexamethasone was given intracamerally from the cataract incision. Each patient
was reevaluated with BCVA, IOP and FFA at 1^st month after surgery.

Results:
Thirty one eye of 18 (%64.3) women and 10 (%35.7) mans who ages ranging from 52
to 87 were enrolled in this study. All of patients had type 2 diabetes. Mean
age of the patients was 65.25±8.57 and 16 (%25.8) eyes had diffuse diabetic
macular edema, 8 (%25.8) eyes had cystoid macular edema and 7 (%22.6)
eyes had both diffuse diabetic macular edema and cystoid
diabetic macular edema. Macular edema did not change in 19 (%61.3) eyes and decreased in 12 (%38.7) eyes. The
mean corrected visual acuity was preoperatively 0.10±0.11, postoperatively 0.2±0.22
at first month. Postoperative increase in vısual acuity was found
statistically significant (p˂0,001).

Conclusion: Intracameral
dexamethasone injection appears to be effective in reducing the effect of
surgery on diabetic macular edema in eyes with diabetic retinopathy and
cataract

Anahtar Kelimeler

Dexamethasone, macular edema, cataract, diabetic retinopathy

Diyabetik retinopatili gözlerde katarakt ameliyatı sonunda ön kamaraya deksametazon verilmesinin makula ödemi üzerine etkisi

Öz

Amaç: Diyabetik retinopati (DR)’li
hastalarda katarakt ameliyatı sonunda ön kamaraya verilen deksametazonun maküla
ödemi (MÖ) üzerine muhtemel etkilerinin araştırılması amaçlanmıştır.

Gereç
ve Yöntem:
Çalışmaya DR’li ve makula ödemi olan 28 katarakt hastası dahil edildi. Bütün
hastalara katarakt operasyonu öncesinde en iyi düzeltilmiş görme keskinlikleri (EDGK),
biyomikroskopik ön segment değerlendirmesi, Goldmann üç aynalı lensi ile fundus
muayeneleri ve Goldmann aplanasyon tonometresi ile göz içi basınç (GİB)
ölçümlerinden oluşan oftalmolojik muayenenin ardından, maküla ödeminin
değerlendirilmesi amacıyla fundus floresein anjiyografi (FFA) çekildi. Katarakt
operasyonunun sonunda hastalara kesi yerinden 0,1 cc deksametazon verildi.
Hastalar birinci ay sonunda EDGK, GİB ve FFA ile değerlendirildi.

Bulgular: Çalışmaya yaşları 52-87 arasında
değişen ve diyabetik makula ödemi (DMÖ) olan 18 (%64,3) kadın ile 10 (%35,7)
erkek hastanın 31 gözü dahil edildi. Hastaların tamamında tip 2 diyabet mevcuttu.
Olguların ortalama yaşı 65,25±8,57 olup
gözlerden 16 (%25,8)’ sında diffüz, 8 (%25,8)’ inde kistoid, 7 (%22,6)’ sinde
hem diffüz hem de kistoid makula ödemi (KMÖ) mevcuttu. 19
(%61,3) hastada  postoperatif makula
ödeminde herhangi bir değişiklik gözlenmezken 12 (%38,7) hastada maküler ödemde
 azalma söz konusuydu (p=0,201). Operasyon öncesi en iyi düzeltilmiş görme keskinliği
0,10±0,11 olup, operasyon sonrası 1.ay görme keskinliği 0,2±0,22
düzeylerindeydi. Bu artış istatistiksel olarak anlamlıydı (p˂0.001).

Sonuç:
DMÖ ve kataraktı
olan gözlerde, katarakt ameliyatı sonunda ön kamaraya deksametazon
uygulamasının, cerrahi işlemin MÖ üzerine olan olumsuz etkisini azalttığı
görülmektedir. 

Anahtar Kelimeler

Deksametazon, makula ödemi, katarakt, diyabetik retinopati

Kaynakça

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