Triamcinolone acetate reduces CME after cataract surgery in diabetic patients but bevacizumab has no additive effect-PREMED Study

Diabetic patients have an elevated risk of CME after cataract surgery that persists to a certain degree even among those receiving the optimum bromfenac and dexamethasone regimen identified in the first PREMED report.

The second report from the PREMED study group indicates that the addition of subconjunctival triamcinolone acetate (TA) can provide a more pronounced reduction of CME after cataract surgery in that group of patients.

The study also suggests that intravitreal injection of bevacizumab has no significant CME-reducing effect. The PREMED investigators randomised 213 diabetic cataract patients to receive no additional treatment, a subconjunctival injection with TA 40 mg, intravitreal bevacizumab 1.25 mg, or a combination of both. By 12 weeks postoperatively, no eyes that received TA developed CME, compared to 7.6 % of those that did not receive it.

The CME incidence was 4.7 % among eyes that received bevacizumab, and 4.3% in eyes that did not receive the anti-VEGF agent.

Author(s): LHP Wielders et al, “European multicenter trial of the prevention of cystoid macular edema after cataract surgery in diabetics: ESCRS PREMED study report 2”, J Cataract Refract Surg 2016, 44:7;836–847.

Source(s): JCRS

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