Role of combined cataract surgery and intravitreal bevacizumab injection in preventing progression of diabetic retinopathy Prospective randomized study

PURPOSE: To evaluate the role of intravitreal bevacizumab, an anti-vascular endothelial growth factor agent, injected at the time of cataract surgery on the postoperative progression of diabetic retinopathy (DR) and diabetic maculopathy. SETTING: Tertiary-care eye specialty hospital, Dhahran, Kingdom of Saudi Arabia. METHODS: Patients were randomized to a standardized procedure of phacoemulsification with intraocular lens implantation alone (control group) or to receive 1.25 mg intravitreal bevacizumab at the end of surgery (intervention group). Diabetic retinopathy and maculopathy were assessed at each postoperative visit during a 6-month follow-up. RESULTS: Sixty-eight eyes (68 patients) with DR and cataract were recruited for this prospective study. Progression of DR occurred in 15 (45.45%) of 33 eyes in the control group and 4 (11.42%) of 35 eyes in the intervention group (P=.002) Progression of diabetic maculopathy occurred in 17 eyes (51.51%) in the control group and 2 eyes (5.71%) in the intervention group (P=.0001). There was no statistically significant difference in postoperative visual acuity between the 2 groups (P=.772). Two eyes in the control group and none in the intervention group progressed to neovascular glaucoma. The mean postoperative central macular thickness and mean macular thickness were not statistically significantly different between the 2 groups (P=.874 and .942, respectively). CONCLUSION: Intravitreal administration of 1.25 mg bevacizumab at the time of cataract surgery was safe and effective in preventing the progression of DR and diabetic maculopathy in patients with cataract and DR.