To study whether or not cataract surgery should be deferred until treating the co-existing diabetic macular edema (DME) using intravitreal (IVI) anti-vascular endothelial growth factor (anti-VEGF).

A prospective randomized interventional study included diabetic patients with visually significant cataract and DME. Patients were divided into 2 groups. Group A received three pre-operative intravitreal Aflibercept injections with a monthly interval, the third injection was given intra-operatively. Group B received a single intra-operative injection, and two post-operative injections with a monthly interval. follow up for 6 months.

Inclusion Criteria:

- Diabetic patients with visually significant cataract

Exclusion Criteria:

• previous vitreoretinal surgery
• laser or intravitreal injections 6 months prior to the procedure
• intractable glaucom
• active intra-ocular inflammation
• retinal detachment
• vitreous hemorrhage
• epi-retinal membranes
• any other retinal vascular or neuroretinal disease.
• Patients with eventual cataract surgeries