Boscia Francesco, Giancipoli Ermete, D'Amico Ricci Giuseppe, Pinna Antonio
aDepartment of Surgical, Microsurgical and Medical Sciences, Ophthalmology Unit, University of Sassari bAzienda Ospedaliero Universitaria di Sassari, Sassari, Italy.
Curr Opin Ophthalmol. 2017 Jan;28(1):23-28. doi: 10.1097/ICU.0000000000000328.
The aim of this study was to describe all the treatment modalities used to prevent and manage macular oedema in diabetic patients undergoing cataract surgery.
Topical NSAIDs have been proposed to be an effective strategy to prevent postsurgical macular oedema (PME) in diabetic patients. The prophylactic use of intravitreal antivascular endothelial growth factors (anti-VEGF) drugs and steroids in these patients, even if effective, brings some concerns with regard to possible side effects. By contrast, in patients with a diagnosis of diabetic macular oedema (DME) at the time of cataract surgery, intravitreal therapy, both with anti-VEGF drugs and steroids, appears to be the best approach in order to control PME and achieve a good visual outcome.
All diabetic patients undergoing cataract surgery should be treated with topical NSAIDs to prevent PME. Intravitreal anti-VEGF drugs and steroids, combined with cataract surgery, should be reserved for patients with preexisting DME.
本研究旨在描述用于预防和管理接受白内障手术的糖尿病患者黄斑水肿的所有治疗方式。
局部使用非甾体抗炎药已被认为是预防糖尿病患者术后黄斑水肿（PME）的有效策略。在这些患者中预防性使用玻璃体内抗血管内皮生长因子（抗VEGF）药物和类固醇，即使有效，也会带来一些关于可能副作用的担忧。相比之下，在白内障手术时被诊断为糖尿病性黄斑水肿（DME）的患者中，玻璃体内注射抗VEGF药物和类固醇治疗似乎是控制PME并获得良好视力结果的最佳方法。
所有接受白内障手术的糖尿病患者都应使用局部非甾体抗炎药治疗以预防PME。玻璃体内抗VEGF药物和类固醇与白内障手术联合应用应仅用于已有DME的患者。
