Abstract
Purpose: :
A prospective, comparative, nonrandomized study to determine whether retinal function improvements occur after 23-gauge vitrectomy in eyes with refractory diffuse diabetic macular edema.
Methods: :
Nineteen eyes of 19 diabetic patients (12 Male, 7 Female; 56 ± 7.5 years) who underwent 23-gauge pars plana vitrectomy for diffuse and refractory diabetic macular edema (DME) were included. Central macular thicknesses (CMTs) were determined by optical coherence tomography (Spectralis OCT, Heidelberg Engineering, Heidelberg, Germany), and retinal sentivities were studied by means of Microperimetry (MP-1, Nidek Technologies, Japan). Visual outcomes, CMTs, and retinal sensitivities were evaluated before and 4, 12 weeks after vitrectomy.
Results: :
Mean preoperative CMTs and mean retinal sentivities were 618.62 ± 126.92 µm and 6.88 ± 1,57dB respectively, the mean CMTs at 4 weeks after vitrectomy was significantly lower than preoperative values (326.85 ± 39.18 µm, P<0.05). The mean retinal sensitivities at 4 weeks follow-up was 7.74 ± 1.12 dB. The mean CMTs at 12 weeks follow-up slightly increased (364.15 ± 37.99 µm) compared to 4 weeks follow up but remained statistically significant compared to preoperative values (P<0.05). The mean retinal sentivity at 12 weeks follow-up was 6.87 ± 1.55 dB, (P<0.05).
Conclusions: :
diabetic macular edema was strongly reduced by 23-gauge vitrectomy after four weeks but it increased after 12 weeks. The retinal sensitivity improved after vitrectomy and remain stable at 12 weeks foolw-up. Mp-1 combined with Spectralis OCT might be routinely used to study retinal function and retinal structure after vitrectomy surgery. Longer follow-up studies are needed.
Keywords: retina • diabetic retinopathy • vitreoretinal surgery