Corticosteroid Injection Combined With Cataract Surgery in Diabetic Eyes.

Exclusion Criteria

• •• A history of diabetes mellitus DM type I that is well-confirmed by an endocrinologist or no history of DM.
• •* CDVA that is better than 20/40.
• •* functionally monocular patient as a result of moderate to severe visual impairment in the contralateral eye, as per the definition of the International Statistical Classification of Diseases and Related Health Problems, 10th revision (6).
• •* The presence of pathologies other than diabetic retinopathy and cataract that may justify visual acuity decline (e.g. corneal disease, age related macular degeneration, macular hole, etc…).
• •* patients will be excluded if they had an increased risk for developing CME in the study eye because of a complication during the current or previous intraocular surgery, intraocular inflammation or uveitis, retinal vein occlusion, or macular pathology that might influence visual function, other than diabetic macular edema.
• •* Patients with pseudoexfoliation syndrome, Fuchs endothelial dystrophy, or post-traumatic cataract in the study eye.
• •* Diabetic retinopathy that falls in one of the following categories according to the International Clinical Diabetic Retinopathy Disease Severity Scale: severe NPDR, proliferative DR, or vitreous hemorrhage requiring pan-retinal photocoagulation or vitrectomy.
• •* Patients who used topical NSAIDs, topical or systemic corticosteroids before surgery.
• •* patients who received an intravitreal injection with any kind of anti-VEGF in the study eye in the previous 6 weeks, or an intraocular or periocular corticosteroid injection in the previous 3 months.
• •* patients who received PRP during the past 3 months.
• •* Contraindications for any of the investigated drugs, particularly patients with glaucoma, IOP of 21mm Hg or higher, previous steroid-induced IOP elevation, or ganglion cell/ RNFL complex injury on OCT image.
• •* History of steroid hypersensitivity.
• •* Patients who are taking steroids PO with a total dosage of more than 5 mg/ day.
• •* Pregnant and breastfeeding ladies.
• •* Previous surgery on the study eye.
• •* systemic bleeding in the previous 3 months, major systemic surgery in the previous 3 months, or a recent or recurrent cerebrovascular accident, myocardial infarction, or thromboembolic event.