Adjuvant Therapies for Diabetic Retinopathy Patients Undergoing Cataract Surgery: a Summary of Current Evidence

Abstract

Aim of this study, review the current evidence on cataract surgery in patients with diabetic retinopathy (DRP) and effect of adjunctivetreatment modalities. A standardized PubMed search was performed and the articles with the highest level of evidence on each clinicalscenario or treatment modality were selected for the purpose of this review. The progression of diabetic retinopathy or the risk of deve-loping of macular edema was not reported to increase after phacoemulsifi cation cataract surgery. In patients with preexisting diabeticmacular edema, cataract surgery was shown to increase macular edema. Adjunctive treatment with intraoperative intravitreal administ-ration of anti-VEGF agents (bevacizumab, ranibizumab) or steroids (triamcinolone, dexamethasone implant) was shown to preventworsening of diabetic macular edema. Current evidence indicated that an adjunctive treatment is only needed in cases with preexistingdiabetic macular edema when performing cataract surgery in diabetic retinopathy patients. While only intravitreal treatment modalitiesshowed improvement in macular edema in such cases, there is no study available comparing the effi cacy or safety of the above-menti-oned treatment options when administered simultaneously with cataract surgery.