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Bevacizumab effective in nonresponsive cystoid macular edema following cataract surgery

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Yoshihide Nakai

SAN FRANCISCO — Intravitreal bevacizumab is effective for treatment of cystoid macular edema after cataract surgery that is non-responsive to steroid or nonsteroid anti-inflammatory drugs, according to a study presented at the American Society of Cataract and Refractive Surgery meeting here.

Cystoid macular edema may form after cataract surgery because of a failure in the blood-brain barrier due to inflammation secondary to surgery, said Yoshihide Nakai, MD.

"Bevacizumab restrains VEGF and it also has the effect of restraining vasopermeability," he said.

Mean best corrected visual acuity improved from 20/60 (range = 20/35 to 20/200) before injection to a mean 20/30 (range = 20/70 to 20/20) at 1 week, 20/25 (range = 20/50 to 20/20) at 1 month and 20/20 at 3 months after injection. Mean thickness of the macula also improved, from 765 µm before bevacizumab injection, to 590 µm at 1 week, 371 µm at 1 month and 225 µm at 3 months after injection.

For the study, 12 patients received a 1.25 mg injection of Avastin (bevacizumab, Genentech) between 6 and 12 weeks after surgery if they did not respond to prior steroid or nonsteroid therapy.