Efficacy of intra vitreous triamcinolone acetate and ranibizumab for profilaxy of macular edema and progression of diabetic retinopathy after facoemulsification with intra ocular lens implant surgery

• Grant number: 09/10225-4
• Support Opportunities: Regular Research Grants
• Start date: May 01, 2010
• End date: April 30, 2013
• Field of knowledge: Health Sciences - Medicine
• Principal Investigator: Walter Yukihiko Takahashi
• Grantee: Walter Yukihiko Takahashi
• Host Institution: Faculdade de Medicina (FM). Universidade de São Paulo (USP). São Paulo , SP, Brazil

Abstract

The prediction to year 2010 is that over 221 million people will have diabetes. The economic expenses related to this disease represent around 5 to 14% of the Brazilian Health resources today. Patients who have a tendency for such illness represent a particular challenge to ophthalmologist towards its propensity for early cataract and this particular condition might lead to a bigger risk on the development of macular edema after cataract surgery The rapid progression of diabetic retinopathy after cataract surgery has already been shown on diabetic patients and it is usually caused by ocular inflammation not only because it was stimulated during the surgical procedure but there are diverse indications that VEGF is also related to the process. The aim of the present study is to evaluate the effectiveness of both 4mg triamcinolone acetate intra vitreous injection and the 0.5mg ranibizumab (Lucentis®) intra vitreous injection in the macular edema prophylaxis and to measure diabetic retinopathy on diabetic people eyes submitted to facoemulsification of the cataract treatment. There for, at the moment of the surgery those injections will be provided and an evaluation will take place from three different prospectives: 1)triamcinolona and facoemulsification, 2) ranibizumabe and facoemulsification 3) facoemulsification (control group). A sample of 27 people is estimated per group.The patients will be examined by ophthalmologists who will measure the visual acuity, perform slit lamp examination; fundus examination; intraocular pressure, retinography; fluoresceine angiography and optic coherence tomography. Laboratory exams like glicosylated hemoglobin and glicemy will be performed. For the following 6 months patients will be observed and the progression of diabetic retinopathy measured according the multicentric study called "Early Treatment Diabetic Retinopathy Study" (ETDRS). The patients who have macular edema diagnosticated will be submitted to laser photocoagulation as the ETDRS indicate. All procedures, purposes and methods will be explained to all patients. (AU)