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CME prevention crucial in diabetic patients who undergo cataract surgery
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ROME — Careful preoperative assessment and, if needed, aggressive treatment of cystoid macular edema in diabetic patients who undergo cataract surgery are mandatory, according to one surgeon speaking here.
"Approximately 15% of all cataract surgeries are in patients with diabetes, and these patients are more likely to develop CME," Keith Warren, MD, said at the annual joint meeting of Ocular Surgery News and the Italian Society of Ophthalmology.
Preoperative evaluation is important to exclude the presence of edema and may need to involve optical coherence tomography or angiography.
"Should the edema be absent, take into account that these patients are at high risk of developing it after surgery due to postoperative inflammation. Pre-treat them with NSAIDs for a week before surgery, and continue this treatment in conjunction with corticosteroids for at least 6 weeks postoperatively. CME is difficult to treat and should be prevented," Dr. Warren said.
Patients with active macular edema should be treated and controlled for at least 3 months before surgery. Available treatments include laser photocoagulation and anti-VEGF therapy.
"Consultation with a vitreoretinal specialist is recommended in these patients," Dr. Warren said.
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