Steroid vs. Anti-vascular Endothelial Growth Factor for Diabetic Macular Edema Prior to Phacoemulsification

Inclusion Criteria: * Age \> 18 years of age * Gender- All * Race- All * Diagnosis of Diabetes (Type 1 or 2) with a concomitant diagnosis of diabetic macular edema as demonstrated on spectral domain optical coherence tomography (Heidelberg Spectralis) * \>250 microns central foveal thickness * Able and willing to provide informed consent Exclusion Criteria: * Significant renal disease * A condition that in the opinion of the investigator would preclude participation * Participation in another investigational trial within 30 days of randomization * Application of focal macular laser within 120 days of enrollment * Administration of Iluvien implant within 3 years of enrollment * Administration of intravitreal triamcinolone within 3 months of enrollment * Administration of any anti-vascular endothelial growth factor agent within 30 days of enrollment * Known hypersensitivity to any of the investigational products * Blood pressure \>180/110 * Women who are pregnant, lactating, or intend to become pregnant within 1 year of randomization * Vulnerable populations- including but not limited to wards of the state, cognitively impaired individuals, prisoners, institutionalized individuals * Individual is planning on moving within 6 months of study enrollment * Macular edema secondary to cause other than diabetic macular edema * Ocular condition that, in the opinion of the investigators, may affect course of macular edema during course of study (vein occlusion, uveitis, etc.) * Evidence of ocular infections * Evidence of uncontrolled glaucoma * Known hypersensitivity to any components of bevacizumab, ranibizumab, aflibercept, or Ozurdex