Journal of Ophthalmology / 2019 / Article / Tab 2

Review Article

A Systematic Review and Meta-Analysis of Clinical Outcomes of Intravitreal Anti-VEGF Agent Treatment Immediately after Cataract Surgery for Patients with Diabetic Retinopathy

Table 2

Characteristics of surgical procedures of IVB or IVR treatment after cataract surgery versus cataract surgery alone included in the meta-analysis.

TrialInclusionExclusionDosageIVB locationLaser photocoagulation during follow-upSurgeon

Salehi et al. [11](1) CSME; (2) mild, moderate, severe, or very severe NPDR or PDR; or (3) a combination of 1 and 2. Patients with previous focal or grid laser photocoagulation for CSME were eligibleThose with previous PRP for PDRIVB: 1.25 mg3.5 mm posterior to the inferotemporal limbus using a 27-gauge needleLaser photocoagulation was performed according to ETDRS guidelinesOne
Fard et al. [12]Moderate or severe NPDR, preoperative visual acuity ≤20/50, preoperative central MT < 200 μmPrior laser photocoagulation in the study eyeIVB: 1.25 mg3.5 mm posterior to limbus with a 30-gauge needlePRP was performed according to ETDRS guidelines for DROne
Takamura et al. [13]NPDR with DME (MT > 300 μm), DME had occurred 3 to 18 months earlier, DME involved the fovea, and BCVA was ≤20/40PDR were excluded. No patients had undergone photocoagulation within the previous 12 monthsIVB: 1.25 mg30-gauge needleNoNR
Lanzagorta-Aresti et al. [14]Moderate NPDR with diffuse macular edema, lasered with macular grid at 2 and 3 months preoperatively, central MT > 200 μmOther associated ocular diseases capable of causing macular edema, patients who had had suffered complications during surgery or in the postoperative periodIVB: 1.25 mg3.5 mm from the limbus via a 30-gauge needleNoSame
Cheema et al. [15](1) CSME; (2) mild, moderate, severe, or very severe NPDR or PDR; or (3) a combination of 1 and 2. Patients with previous focal or grid laser photocoagulation for CSME were eligibleThose with previous PRP for PDRIVB: 1.25 mg3.0 to 3.5 mm from the limbus with a 27-gauge needleLaser photocoagulation was performed according to ETDRS guidelinesSame
Chae et al. [16](1) Patients with NPDR, or patients with stable DR, who had completed PRP at least 3 months earlier; (2) patients with visually significant cataract with BCVA under 20/30; (3) patients with central subfield thickness (CST) that was <300 μmAny kind of intravitreal drug injection within the previous 3 months; retinal laser treatment of diabetic ME within the previous 3 months, conditions (e.g., chronic ME, anatomical macular problem, and severe macular infarction) that the investigators believed are associated with a low probability of visual acuity restorationIVR: 0.5 mg3 mm posterior to the limbusAdditive PRP due to vitreous hemorrhageFour surgeons
Lin et al. [17]NPDR without clinical DMEPDR was excluded, any kind of intravitreal drug injection preoperativelyIVR: 0.5 mgNRNoOne
Lu et al. [18]NPDR with clinical DMEIVR: 0.5 mg3.5 mm posterior to the inferotemporal limbusNoOne
Cheng et al. [19]NPDR without clinical DMEIVR: 0.5 mgNoNR
Li [20]NPDR with clinical DMEPDR, AMD, high myopia, intraocular surgery historyIVR: 0.5 mgNRNoOne
Chen et al. [21]Diffuse central macular edema of at least 250 mm, as demonstrated by OCTReceived laser photocoagulation less than 3 months before enrollment; concurrent PDR; IV injection of drugs within 6 monthsIVB: 2.5 mg3.5 mm posterior to the inferotemporal limbus
Udaondo et al. [22]Mild to moderate NPDR without clinical DMEPrevious DME treated or not, any kind of complication during the surgery, other ocular pathology with macular involvementIVR: 0.5 mgNRNoSame

IVB = intravitreal bevacizumab; IVR = intravitreal ranibizumab; PDR = proliferative diabetic retinopathy; NPDR = nonproliferative diabetic retinopathy; MT = macular thickness; PRP = panretinal photocoagulation; NR = not reported; DR = diabetic retinopathy; CSME = the presence of clinically significant macular edema; BCVA = best-corrected visual acuity; DME = diabetic macular edema; ETDRS = the early treatment diabetic retinopathy study.

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