Intravitreal bevacizumab vs. triamcinolone in patients with DMO at the time of cataract surgery
Reviewed by Anjali Gupta

This prospective, single masked randomised control trial (RCT) compared visual and anatomical outcomes when either intravitreal bevacizumab (BVB) or triamcinolone (TA) was administered at the time of cataract surgery and at subsequent review, if required, in patients with diabetic macula oedema (DMO). Patients with refractory DMO, or a recent history of treated DMO, with visually significant age-related cataract were included. Participants were randomised 1:1 to receive intravitreal BVB or TA during cataract surgery, and at subsequent review if required over six months. Forty-one patients were included for analysis. VA improved in both the BVB and TA groups, with no significant difference between groups. However, TA was associated with a mean post baseline decrease in central macular thicknes (CMT), while BVB was associated with a mean increase in CMT; 70.6% participants in the BVB group required further injections, compared with 16.7% in the TA group. There were no cases of IOP rise in the BVB group, compared with 12.5% in the TA group. The authors conclude that when administered at the time of cataract surgery in patients with DMO, at six months both TA and BVB improve VA, however, only TA results in a sustained decrease in CMT. Further follow-up is required to assess longer-term visual outcomes in the TA group.

Diabetic macule edema at the time of cataract surgery trial: a prospective, randomised clinical trial of intravitreous bevacizumab versus triamcinolone in patients with diabetic macula oedema at the time of cataract surgery – preliminary 6 month results.
Lim LL, Morrison JL, Constantinou M, et al.
CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY
2016;44:233-42.