Phacoemulcification with intravitreal bevacizumab injection in patients with cataract and coexisting diabetic retinopathy: prospective randomized study

Abstract

Objective: To evaluate efficacy of intravitreal injection of bevacizumab at the time of cataract surgery on the postoperative progression of diabetic retinopathy (DR) and diabetic maculopathy.

Methods: Patients were randomized to a standardized procedure of phacoemulsification with intraocular lens implantation alone (control group; 30 eyes) or to receive 1.25 mg intravitreal bevacizumab (0.05 mL of solution prepared from avastin, 100 mg/4 mL vial) at the end of surgery (IVB group; 27 eyes). Efficacy measures included best-corrected visual acuity (BCVA) testing, optical coherence tomography (OCT), and ophthalmoscopic examination at each postoperative visit during a 6-month follow-up.

Results: There were no significant differences in central macular thickness (CMT), BCVA, or systemic condition between the control and IVB groups at baseline. Progression of diabetic maculopathy occurred in 15 eyes (50%) in the control group and 2 eyes (7.4%) in the intervention group (P = 0.0008). There was no statistically significant difference in postoperative visual acuity between the 2 groups after 6 months (P = 0.5). Five eyes in the control group and 1 eye in the intervention group progressed to neovascular glaucoma. Difference in mean postoperative CMT was not statistically significant between both groups (P = 0.54).

Conclusions: Intravitreal administration of 1.25 mg bevacizumab at the time of cataract surgery was safe and effective in preventing the progression of DR and diabetic maculopathy in patients with cataract and DR.