Intravitreal pharmacologic therapy during cataract surgery in patients with diabetic macular edema: Short-term anatomical and functional outcomes

Objectives: The aim of this study was to evaluate the anatomical and functional outcomes of different intravitreal pharmacologic therapies administered during cataract surgery in patients with diabetic macular edema (DME). Material and Methods: A comparative clinical study was conducted in patients with DME undergoing phacoemulsification with intraocular lens implantation. Participants received intravitreal pharmacologic therapy at the time of surgery, including anti-vascular endothelial growth factor agents, corticosteroids, or combined therapy. Best-corrected visual acuity and macular anatomical parameters measured by optical coherence tomography, including central macular thickness (CMT), area of greatest edema (AGE), and total macular volume (TMV), were evaluated preoperatively and during post-operative follow-up. Results: Visual acuity improved significantly in all treatment groups following cataract surgery. A numerical reduction in CMT, AGE, and TMV was observed only in the combination therapy group compared with baseline. However, no statistically significant between-group superiority was detected at the 6-week endpoint. Given the limited sample size, these non-significant findings should not be interpreted as evidence of equivalence among treatment strategies. Conclusion: Intraoperative intravitreal bevacizumab, triamcinolone acetonide, or their combination was associated with significant short-term visual improvement after phacoemulsification in eyes with DME. The combination group showed numerical anatomical reductions, but no statistically significant superiority over either monotherapy group was detected. Given the limited sample size and short follow-up, these findings should be considered exploratory.