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R.M. Romero, J.P. Sinisterra-Pava, J.L. Guerrero-Naranjo, H. Quiroz-Mercado, J. Fromow-Guerra; Pars Plana Vitrectomy for the Management of Diabetic Macular Edema 1 Year of Follow Up . Invest. Ophthalmol. Vis. Sci. 2003;44(13):3961.
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Purpose: To evaluate the effect of pars plana vitrectomy in the managment of clinically significant macular edema (CSME)in none proliferative diabetic retinopathy patient after 1 year of follow up. Methods: Prospective interventional and longitudinal study. We report 6 patients: 3 male and 3 female with mild to severe non proliferative diabetic retinopathy and diffuse clinically significant macular edema (CSME) on both eyes. All of the patients were evaluated with a general ophthamological examination best visual acuity, multifocal electroretinogram (mERG), macular thickness measured by optical coherence tomography (OCT) and fluorescein angiography. After the initial evaluation and signed out the informed consent format (IRB).all of them went to pars plana vitrectomy with posterior hyaloid removal in the eye with worst visual acuity. All of them were evaluated 1,2 week, 1,3,6 month and 1 year after the surgery. None of the vitrectomized eyes were treated with laser photocoagulation in the macular area. Results: The first 6 months after the surgery 100% of the patients decrease visual acuity in the eye who undewent pars plana vitrectomy. At 6 months visit all showed the same visual acuity than before surgery. After 1 year of follow up 75% of the patients gained 2 lines of vision ETDRS chart and 2 patients gained 1 lines of vision ETDRS chart. The 1 year follow visit macular area showed a lesser thickness by OCT, and the visual function were better by multifocal ERG. and fluorescein angiography showed non progression of the diabetic retinopathy Conclusions: Pars plana vitrectomy with posterior hialoid removal surgical reduce the risk of severe vision loss from proliferative diabetic retinopathy. In our study we had few patients and all of them decrease visual acuity after the first 6 months of the surgery but after 1 year of follow up they gain visual acuity with none progression of the disease Pars plana vitrectomy is one of the possible treatments for patients with none proloiferative diabetic retinopathy and diffuse clinical significance macular edema.
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