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Alessandro J. Dare, Jose A. Cardillo, Rogerio A. Costa, Eduardo Moreira, Francyne Tognin; Gas-Assisted Posterior Vitreous Detachment For The Treatment Of Diabetic Macular Edema. Invest. Ophthalmol. Vis. Sci. 2012;53(14):352.
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To assess the functional and anatomic outcomes of a single intravitreous perfluoropropone (C3F8) gas injection to treat patients with tractional DME, as assessed by optical coherence tomography (OCT).
Five patients previously treated with focal grid photocoagulation, with tractional diabetic macular edema received an intravitreous gas injection and were prospectively followed with optical coherence tomography. After informed consent was obtained, the compromised eye was injected with 0.4 ml C3F8 gas using a 30-gauge needle via the pars plana. Patients maintained a head-prone posture for 14 days. Changes in vitreous-macular relationship and central macular thickness were assessed using optical coherence tomography. Patients were followed 1 week, 2 weeks, 1, 2, 3, and 6-months after treatment. ETDRS best correct visual acuity and fluorescein angiography were assessed during follow up.
A complete posterior vitreous detachment was achieved within 4 weeks after gas injection in 3 of the 5 patients. By 6 months of follow-up after induced separation of the hyaloid at the fovea, there was resolution of the macular edema and restoration of the foveal depression. No complication was related to the procedure. Vitrectomy were performed in those patients whom completed vitreous detachment were not obtained with gas injection.
The pneumatically-assisted vitreofoveal separation is a relative simple outpatient procedure with minimal surgical manipulation and low morbidity that may have broad therapeutic use.
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