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J. I. Patel, R. Rajendram, Z. Gregor, P. Hykin; Retrospective Long-Term Review of Vitrectomy for Diabetic Macular Edema. Invest. Ophthalmol. Vis. Sci. 2010;51(13):5078.
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© ARVO (1962-2015); The Authors (2016-present)
To report on the long term results of pars plana vitrectomy (PPV) for nontractional diffuse diabetic macular edema.
A retrospective review of the records from patients who had been recruited into three previously conducted prospective clinical trials of the effect of PPV for nontractional diffuse diabetic clinically significant macular edema (CSME), one of which was a pilot randomised study comparing PPV against standard ETDRS argon laser treatment. These trials had 12 months follow-up of their own.
Twenty-eight patients were recruited in the initial trials for PPV, and 10 patients were recruited to the laser arm of the randomised study. A retrospective seven-year review of 17 PPV patients and 7 laser patients was performed, the rest were lost to follow up. The median logMar visual acuity (VA) for PPV group remained stable after 7 years (0.48 [range 0.3-1]) whilst in the laser group the VA slightly improved form baseline 0.48 [range 0.3-1] to a 7 year follow up 0.45 logMar [range 0.3-0.6]. There was no significant difference in the logMar visual acuities between PPV and laser at baseline and at 7 years follow up. The PPV group did show resolution of CSME in a median time of 2 years (range 1-4 years) with all patients showing resolution of CSME. The laser group also showed resolution of CSME in a median time of 2 years (range 0-4 years) but three of the seven showed no resolution of CSME. In the PPV group one patient progressed to proliferative retinopathy within 2 years of surgery (with moderate nonproliferative retinopathy (NPDR) at baseline for the group) whilst in the laser group three of the seven progressed to proliferative disease (mild to moderate NPDR at baseline for the group).
This is a 7 year retrospective review of patients recruited to three prospective clinical trials which themselves only had 12 month follow up, of PPV for diffuse diabetic macular edema, demonstrated that there is no long term VA benefit for PPV in nontractional diabetic CSME.
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