Dexamethasone Intravitreal Injection in Diabetic Patients Undergoing Cataract Surgery: an updated literature review.

Abstract

Purpose: This literature review synthetizes current evidence on the timing and efficacy of dexamethasone intravitreal injections for diabetic macular edema (DME) in patients undergoing cataract surgery, particularly phacoemulsification, to determine the optimal timing for improved outcome.

Methods: A systematic review of the literature was conducted across key databases to identify peer-reviewed studies, clinical trials, and meta-analyses addressing dexamethasone injections administered pre-, intra-, and post-operatively for DME in the context of cataract surgery. Studies were selected based on relevance to timing, visual outcomes, and inflammation control, with a focus on comparative efficacy.

Results: The findings suggest that timely dexamethasone injections can substantially reduce inflammation and enhance visual recovery for patients with DME undergoing cataract surgery. Studies indicate that preoperative injections may effectively dampen the inflammatory response triggered by surgical trauma, potentially preserving retinal integrity, while intraoperative and postoperative administrations contribute to sustained anti-inflammatory effects during the recovery phase. Comparative studies also highlight dexamethasone's advantages over other anti-inflammatory treatments, such as NSAIDs, particularly in preventing cystoid macular edema. Notably, there was considerable variation in dosage and timing across studies, underscoring the need for standardized treatment protocols.

Conclusions: Dexamethasone intravitreal injections offer a valuable intervention for managing DME in diabetic patients undergoing cataract surgery, with optimal timing playing a crucial role in maximizing therapeutic benefits. Preoperative injections appear to be particularly beneficial in reducing the risk of postoperative inflammatory complications. Further research should focus on developing comprehensive guidelines for timing and dosage to standardize treatment and improve patient outcomes in this high-risk population.