Corticosteroid Injection Combined With Cataract Surgery in Diabetic Eyes.

This is an interventional prevention trial for Diabete Type 2 focused on measuring diabetes, phacoemulsification, intravitreal, triamcinolone acetonide, diabetic retinopathy, central subfield macular thickness, CSMT, CDVA, IOP Read More

Inclusion Criteria:

• ● A history of diabetes mellitus DM type II that is well-confirmed by an endocrinologist.

  • Senile cataract that is causing visual disturbance as demonstrated by clinical examination.
  • CDVA of no more than 20/ 40, finger count and hand movement vision are included. Too.
  • Diabetic retinopathy that falls in one of the following categories according to the International Clinical Diabetic Retinopathy Disease Severity Scale: No DR- mild NPDR- moderate NPDR.
  • A healthy-looking central macula, or Clinically Significant Macular Edema (CSME), or edema that is apparent on Fundus Fluorescent Angiography (FFA) or OCT, as well as a treatment-resistant diabetic macular edema in the past 24 months or microaneurysms at foveal avascular zone (FAZ) borders not amenable to laser therapy.
  • Both sexes, Age 18 years or older.
  • One eye per patient will be included.
  • The surgery will be performed by the same surgeon and the samIOL design will be used.

Exclusion Criteria:

• • A history of diabetes mellitus DM type I that is well-confirmed by an endocrinologist or no history of DM.

  • CDVA that is better than 20/40.
  • functionally monocular patient as a result of moderate to severe visual impairment in the contralateral eye, as per the definition of the International Statistical Classification of Diseases and Related Health Problems, 10th revision (6).
  • The presence of pathologies other than diabetic retinopathy and cataract that may justify visual acuity decline (e.g. corneal disease, age related macular degeneration, macular hole, etc…).
  • patients will be excluded if they had an increased risk for developing CME in the study eye because of a complication during the current or previous intraocular surgery, intraocular inflammation or uveitis, retinal vein occlusion, or macular pathology that might influence visual function, other than diabetic macular edema.
  • Patients with pseudoexfoliation syndrome, Fuchs endothelial dystrophy, or post-traumatic cataract in the study eye.
  • Diabetic retinopathy that falls in one of the following categories according to the International Clinical Diabetic Retinopathy Disease Severity Scale: severe NPDR, proliferative DR, or vitreous hemorrhage requiring pan-retinal photocoagulation or vitrectomy.
  • Patients who used topical NSAIDs, topical or systemic corticosteroids before surgery.
  • patients who received an intravitreal injection with any kind of anti-VEGF in the study eye in the previous 6 weeks, or an intraocular or periocular corticosteroid injection in the previous 3 months.
  • patients who received PRP during the past 3 months.
  • Contraindications for any of the investigated drugs, particularly patients with glaucoma, IOP of 21mm Hg or higher, previous steroid-induced IOP elevation, or ganglion cell/ RNFL complex injury on OCT image.
  • History of steroid hypersensitivity.
  • Patients who are taking steroids PO with a total dosage of more than 5 mg/ day.
  • Pregnant and breastfeeding ladies.
  • Previous surgery on the study eye.
  • systemic bleeding in the previous 3 months, major systemic surgery in the previous 3 months, or a recent or recurrent cerebrovascular accident, myocardial infarction, or thromboembolic event.