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Anti-VEGF Intravitreous Injections for Diabetic Macular Edema in Patients Undergoing Cataract Surgery

Phase 3
Conditions
Diabetic Macular Edema
Cataract
Interventions
Registration Number
NCT04063358
Lead Sponsor
Second Military Medical University
Brief Summary

The investigators aim to evaluate how different timing of anti-VEGF intravitreous injections affect visual acuity (BCVA) in patients with diabetic macular edema who are undergoing cataract surgery; and to evaluate how different timing of anti-VEGF intravitreous affect OCT CSF thickness and total number of postoperative injections in patients with diabetic macular edema who are undergoing cataract surgery.

Detailed Description

Cataract is very common in diabetic patients and can lead to significant vision loss and disability without medical intervention. Diabetic patients, particularly those with diabetic macular edema (DME), experience poorer visual outcomes after undergoing cataract surgery compared to non-diabetics. An increased risk in the development of post-operative cystoid macular edema and exacerbation of baseline DME is reported and this poses a significant challenge in managing concomitant DME and visually-significant cataracts.

Goals of the study are to evaluate how different timing of anti-VEGF intravitreous injections (before operation, intra-operation or after-operation) affect visual acuity (BCVA) in patients with persistent diabetic macular edema who are undergoing cataract surgery; and to evaluate how different timing of anti-VEGF intravitreous injections affect OCT CSF thickness and total number of postoperative injections in patients with diabetic macular edema who are undergoing cataract surgery.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
90
Inclusion Criteria

Adults over age 18 with diabetes mellitus, diabetic macular edema and visually significant cataracts planning to undergo cataract surgery

Exclusion Criteria

Patients who have undergone panretinal photocoagulation (PRP) in prior 4 months or an ocular condition (other than cataract and DME) that might affect visual acuity during course of study.

Patients with history of vitrectomy. Patients with neovascular glaucoma

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Lucentis injected intra-operativelyLucentisLucentis injected during the course of the surgery by cataract surgeon.
Lucentis injected post-operativelyLucentisLucentis injected 2 weeks after cataract surgery
Lucentis injected Pre-operativelyLucentisLucentis injected 2 weeks before cataract surgery
Primary Outcome Measures
NameTimeMethod
Change in best-corrected visual acuity (BCVA)1 month, 3 months , 6 months and 12 months after cataract surgery

BCVA is a measurement of the best vision correction that can be achieved, such as glasses, as measured on the standard Snellen eye chart. For example, if uncorrected eyesight is 20/200, but patient can see 20/20 with glasses, the BCVA is 20/20.

Change in optical coherence tomography (OCT) central subfield (CSF) thickness24 hours post-operatively, 1 month, 3 months , 6 months and 12 months after cataract surgery

Optical coherence tomography (OCT) is an important imaging modality in the evaluation and management of retinal diseases. Change in central subfield (CSF) thickness will be measured and recorded.

Secondary Outcome Measures
NameTimeMethod
Total number of postoperative injections12 months after cataract surgery

Total number of postoperative injections will be calculated

percentage of patients with diabetic retinopathy progression12 months after cataract surgery

patients with diabetic retinopathy progression will be calculated

Trial Locations

Locations (1)

Changhai Hospital

🇨🇳

Shanghai, Shanghai, China

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