Department of Medical Science, Neuroscience and Sense Organs, Eye Clinic, Azienda Ospedaliero-Universitaria Policlinico Consorziale Bari, Italy.
Department of Medical Science, Neuroscience and Sense Organs, Eye Clinic, University of Bari, Bari, Italy.
Retina. 2021 May 1;41(5):1102-1109. doi: 10.1097/IAE.0000000000002974.
To compare functional and anatomical results of combined phacoemulsification and dexamethasone intravitreal implant (Ozurdex; DEX-I) with standard phacoemulsification in diabetic patients with cataract.
Retrospective, comparative, cohort study. Patients with nonproliferative diabetic retinopathy, macular edema, and cataract, treated routinely at the Eye Clinic, Azienda Ospedaliero Universitaria Policlinico, Bari, Italy with phacoemulsification associated with DEX-I (n = 23; Phaco-Dex) or standard phacoemulsification (n = 23; Phaco-alone). Best-correct visual acuity, central subfield thickness, and intraocular pressure were assessed at baseline and monthly for 3 months after surgery, and t-test was used to assess change from baseline. A multilevel regression model with an unstructured correlation-type matrix to account for repeated data measures was used for statistical analysis in and between groups.
With Phaco-Dex, best-correct visual acuity increased significantly from the first month (P = 0.0005 vs. baseline) and remained stable at the following visits; central subfield thickness decreased significantly from Month 2 (P = 0.049 and P = 0.04 vs. baseline, respectively); at each timepoint, central subfield thickness was significantly lower in the Phaco-Dex group versus Phaco-alone. Intraocular pressure increased significantly during follow-up (P = 0.001 at Month 3 vs. baseline) but remained within the normal range. In the Phaco-alone group, best-correct visual acuity, and intraocular pressure did not show any significant changes after surgery, whereas central subfield thickness increased from Month 2 (P = 0.05 vs. baseline).
In diabetic patients with macular edema and visually significant cataract, combined treatment with phacoemulsification and DEX-I seemed to be effective, safe, and superior to standard phacoemulsification considering both functional and tomographic parameters.
比较白内障超声乳化术联合地塞米松玻璃体内植入（Ozurdex；DEX-I）与单纯白内障超声乳化术治疗糖尿病合并白内障患者的功能和解剖结果。
回顾性、对照、队列研究。意大利巴里 Azienda Ospedaliero Universitaria Policlinico 眼科诊所常规治疗非增生性糖尿病视网膜病变、黄斑水肿和白内障的患者，随机分为白内障超声乳化术联合 DEX-I 治疗组（Phaco-Dex，n=23）和单纯白内障超声乳化术治疗组（Phaco-alone，n=23）。在基线和术后 3 个月每月评估最佳矫正视力、中央视网膜厚度和眼压，并使用 t 检验评估与基线相比的变化。使用具有非结构化相关型矩阵的多层次回归模型来分析组内和组间的重复数据测量。
Phaco-Dex 组术后第一个月最佳矫正视力显著提高（P=0.0005 与基线相比），随后几个月保持稳定；中央视网膜厚度从术后第二个月开始显著降低（P=0.049 和 P=0.04 与基线相比）；在每个时间点，Phaco-Dex 组的中央视网膜厚度均显著低于 Phaco-alone 组。术后随访期间眼压显著升高（P=0.001 与基线相比），但仍在正常范围内。Phaco-alone 组术后最佳矫正视力和眼压无明显变化，而中央视网膜厚度从术后第二个月开始增加（P=0.05 与基线相比）。
对于合并黄斑水肿和明显白内障的糖尿病患者，白内障超声乳化术联合 DEX-I 治疗可能是一种有效、安全的治疗方法，在功能和影像学参数方面均优于单纯白内障超声乳化术。
