Clinical Study Combined Phacoemulsification and Intravitreal Dexamethasone Implant (Ozurdex®) in Diabetic Patients with Coexisting Cataract and Diabetic Macular Edema Claudio Furino, 1 Francesco Boscia, 2 Alfredo Niro, 1 Ermete Giancipoli, 2 Maria Oliva Grassi, 1 Giuseppe D’amico Ricci, 2 Francesco Blasetti, 2 Michele Reibaldi, 3 and Giovanni Alessio 1 1 Department of Medical Science, Neuroscience and Sense Organs, Eye Clinic, University of Bari, Bari, Italy 2 Department of Surgical, Microsurgical and Medical Sciences, Eye Clinic, University of Sassari, Sassari, Italy 3 Eye clinic, University of Catania, Catania, Italy Correspondence should be addressed to Alfredo Niro; alfred.nir@tiscali.it Received 21 May 2017; Revised 11 July 2017; Accepted 31 July 2017; Published 13 August 2017 Academic Editor: Lisa Toto Copyright © 2017 Claudio Furino et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Purpose. To investigate the effectiveness and safety of combined phacoemulsification and dexamethasone intravitreal implant in patients with cataract and diabetic macular edema. Methods. In this two-center, retrospective, single-group study, the charts of 16 consecutive patients who underwent combined phacoemulsification and intravitreal dexamethasone implant were retrospectively reviewed. These 16 patients, 7 men and 9 women, were observed at least 3 months of follow-up. Primary outcome was the change of the central retinal thickness (CRT); secondary outcome was the change of best-corrected visual acuity (BCVA). Any ocular complications were recorded. Results. Mean CRT decreased significantly from 486 ± 152.4 μm at baseline to 365.5 ± 91 μm at 30 days (p = 005), to 326 ± 80 μm at 60 days (p = 0004), and to 362 ± 134 μm at 90 days (p = 001). Mean BCVA was 20/105 (logMAR, 0.72 ± 0.34) at baseline and improved significantly (p ≤ 007) at all postsurgery time points. One case of ocular hypertension was observed and successfully managed with topical therapy. No endophthalmitis or other ocular complications were observed. Conclusion. Intravitreal slow-release dexamethasone implant combined with cataract surgery may be an effective approach on morphologic and functional outcomes for patients with cataract and diabetic macular edema for at least three months after surgery. 1. Introduction Diabetes mellitus is associated with a 5-fold higher prevalence of cataract compared to the nondiabetic population [1]. Thus, cataract extraction is a frequently performed surgical proce- dure in patients with diabetes. Compared to nondiabetic cata- ract patients, this surgery is associated with a higher risk of complications in diabetic patients, including postsurgical development of cystoid macular edema (also called Irvine- Gass syndrome) or worsening of preexisting macular edema [2–4]. Diabetic macular edema (DME) is a complication of diabetic retinopathy and is the most common cause of visual loss in both proliferative and nonproliferative diabetic reti- nopathy. Approximately 20% of the patients with diabetic retinopathy are affected by macular edema [5]. Currently, there is no standard treatment approach for improving outcomes of cataract extraction in diabetic patients with different degrees of clinically significant macular edema. Previous papers proposed a combined approach with intravit- real injection of humanized anti-VEGF monoclonal antibod- ies (ranibizumab, bevacizumab) or triamcinolone acetonide and cataract surgery in patient with DME [6–12]. In a prospec- tive, randomized clinical trial of intravitreous bevacizumab versus triamcinolone when administered at the time of cata- ract surgery, both groups gained vision but only triamcinolone acetonide was associated with a sustained reduction in central macular thickness after six months [13]. Dexamethasone intravitreal implant (Ozurdex®; Allergan Inc., Irvine, CA, USA) is a biodegradable implant that releases a small amount (700 μg) of the glucocorticoid dexamethasone Hindawi Journal of Ophthalmology Volume 2017, Article ID 4896036, 7 pages https://doi.org/10.1155/2017/4896036