Long–Term Outcome After Vitrectomy in Diabetic Macular Edema

Abstract

Abstract: : Purpose: To determine the benefit of vitrectomy on eyes with diabetic macular edema. Methods: Retrospective institutional case series including 66 patients (69 eyes) who had undergone pars plana vitrectomy for diabetic macular edema between 1992 and 2000. Prior to surgery the patients had been treated with either focal or grid lasercoagulation as recommended by the EDTRS. In case of persistent macular edema vitrectomy with removal of the posterior hyaloid in all cases and the inner limiting membrane in 51 (73.9%) of all cases was performed. In 14 eyes (20.6%) of the patients cataract extraction was done simultaneously. Results: The mean preoperative best– corrected visual acuity improved from 20/320 to 20/80 at the time of best postoperative best– corrected visual acuity (P<0.0001, Wilcoxon signed rank test). The mean increase in Snellen lines was 2.7±7.9. In 90.2% of eyes the macular edema improved. A persistence of the edema was observed in 9.8%. All eyes had at least 12 months follow up with a mean of 54.7 months and a maximum of 120 months. Conclusions: Our findings confirm that even in respect to long term follow up vitrectomy might represent a therapeutic alternative in case of persisting diabetic macular edema after laser photocoagulation.

Keywords: diabetic retinopathy • vitreoretinal surgery