Safety and efficacy of a standardized intracameral combination of mydriatics and anesthetic for cataract surgery in type-2 diabetic patients [Elektronisk resurs]
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Labetoulle, Marc (författare)
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Behndig, Anders (författare)
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Tassignon, Marie-José (författare)
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Nuijts, Rudy (författare)
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Mencucci, Rita (författare)
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Güell, José Luis (författare)
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Pleyer, Uwe (författare)
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Szaflik, Jacek (författare)
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Rosen, Paul (författare)
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Bérard, Alain (författare)
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Chiambaretta, Frédéric (författare)
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Cochener-Lamard, Béatrice (författare)
- Publicerad: BioMed Central, 2020
- Engelska.
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Ingår i: BMC Ophthalmology. - 1471-2415. ; 20:1
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- Relaterad länk:
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http://www.umu.se/ (Värdpublikation)
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- BACKGROUND: Cataract surgery in diabetics is more technically challenging due to a number of factors including poor intraoperative pupil dilation and a higher risk of vision threatening complications. This study evaluates the safety and efficacy of an intracameral combination of 2 mydriatics and 1 anesthetic (ICMA, Mydrane) for cataract surgery in patients with well-controlled type-2 diabetes. METHODS: Post-hoc subgroup analysis of a phase 3 randomized study, comparing ICMA to a conventional topical regimen. Data were collected from 68 centers in Europe and Algeria. Only well-controlled type-2 diabetics, free of pre-proliferative retinopathy, were included. The results for non-diabetics are also reported. The primary efficacy variable was successful capsulorhexis without additional mydriatic treatment. Postoperative safety included adverse events, endothelial cell density and vision. RESULTS: Among 591 randomized patients, 57 (9.6%) had controlled type 2 diabetes [24 (42.1%) in the ICMA Group and 33 (57.9%) in the Topical Group; intention-to-treat (ITT) set]. Among diabetics, capsulorhexis was successfully performed without additional mydriatics in 24 (96.0%; modified-ITT set) patients in the ICMA Group and 26 (89.7%) in the Topical Group. These proportions were similar in non-diabetics. No diabetic patient [1 (0.5%) non-diabetics] in the ICMA Group had a significant decrease in pupil size (≥3 mm) intraoperatively compared to 4 (16.0%; modified-ITT set) diabetics [16 (7.3%) non-diabetics] in the Topical group. Ocular AE among diabetics occurred in 2 (8.0%; Safety set) patients in the ICMA Group and 5 (16.7%) in the Topical Group. Endothelial cell density at 1 month postoperatively was similar between groups in diabetics (P = 0.627) and non-diabetics (P = 0.368). CONCLUSIONS: ICMA is effective and can be safely used in patients with well-controlled diabetes, with potential advantages compared to a topical regimen including reduced systemic risk, better corneal integrity and reduced risk of ocular complications. TRIAL REGISTRATION: The trial was registered at (reference # NCT02101359) on April 2, 2014.
Ämnesord
- Medical and Health Sciences (hsv)
- Clinical Medicine (hsv)
- Ophthalmology (hsv)
- Medicin och hälsovetenskap (hsv)
- Klinisk medicin (hsv)
- Oftalmologi (hsv)
Genre
- government publication (marcgt)
Indexterm och SAB-rubrik
- Anesthetics
- Cataract surgery
- Diabetes
- Intracameral
- Mydrane
- Mydriatics
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BMC Ophthalmology