AIM: To observe the therapeutic effects of phacoemulsification combined with intravitreal injection of triamcinolone(IVTA)in treating cataract with diabetic macular edema.

METHODS: Forty-four patients(52 eyes)with cataract and diabetic macular edema were randomly divided into two groups: the control group and the IVTA group. Twenty-six eyes in the control group underwent phacoemulsification and intraocular lens implantation. Additionally, 26 eyes in the IVTA group were treated with IVTA at completion of the surgery. Results of best corrected visual acuity(BCVA), optical coherence tomography(OCT)and ophthalmological examination were analyzed. Before and after the treatment, differences of Logarithm of the minimum angle of resolution(LogMAR BCVA)in groups were compared, as well as the central macular thickness(CMT). Correlations between LogMAR BCVA and other factors were analyzed by Pearson correlation analysis. Six months after the operation, multivariate liner regression analysis was taken to evaluate the correlations between LogMAR BCVA and affecting factors.

RESULTS:LogMAR BCVA in both groups were improved significantly at 3 time points(1, 3 and 6mo respectively)after the surgery(F=3.351,4.588, P=0.022,0.005). No significant difference in LogMAR BCVA between groups were found(P>0.05). One month or 3mo after the surgery(but not 6mo), the IVTA group showed thinner CMT than the control group(t=3.402,2.083, P=0.001, 0.042). Six months after the operation, the mean LogMAR BCVA negatively correlated with the ELM state of the patients(r=-0.611, P=0.006). Results of multivariate liner regression analysis showed that the visual recovery in 6mo after the surgery was affected by the external limiting membrane status(B=0.333,P=0.030)and the duration of diabetes(B=-0.307, P=0.005).

CONCLUSION: Phacoemulsification combined with IVTA is effective in treating patients with cataract and diabetic macular edema by reducing edema and improving their visual acuity. But IVTA is more effective in reducing edema than improving LogMAR BCVA.