Abstract | PURPOSE: DESIGN: Interventional, retrospective, consecutive case series. METHODS: Clinical records of 332 consecutive patients (496 eyes) with diabetic macular edema without a thickened and taut posterior hyaloid on contact lens examination were reviewed. Four hundred eighty-six eyes of 326 consecutive patients were included in this study. All patients underwent pars plana vitrectomy with the creation of a posterior vitreous detachment by one surgeon. Simultaneous phacoemulsification with intraocular lens implantation was performed on 456 phakic eyes. Internal limiting membrane peeling was performed on 178 (36.6%) of 486 eyes. The main outcome measured was best-corrected visual acuity results during follow-up periods. RESULTS: Postoperative follow-up ranged from 12 to 170 months (mean, 74.0 months). Five year follow-up data were available for 356 (71.8%) of 496 eyes. Mean preoperative best-corrected visual acuity significantly increased from 0.19 (20/105) to 0.32 (20/63) at 1 year after surgery (P < 0.0001), and 0.30 (20/67) at the final visit (P < 0.0001). The final best-corrected visual acuity improved in 256 (52.7%) of the 486 eyes, remained unchanged in 152 eyes (31.3%), and worsened in 78 eyes (16.0%). Postoperative major complications included neovascular glaucoma in 19 eyes (3.9%), recurrent vitreous hemorrhage in 10 eyes (2.1%), hard exudate deposits in the center of the macula in 21 eyes (4.2%), and glaucoma in 22 eyes (4.5%). CONCLUSIONS: Pars plana vitrectomy with and without internal limiting membrane peeling appears to be beneficial in eyes with diffuse nontractional diabetic macular edema, and its effectiveness is maintained long term.
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Authors | Kazuyuki Kumagai, Mariko Furukawa, Nobuchika Ogino, Eric Larson, Masayoshi Iwaki, Naoko Tachi |
Journal | Retina (Philadelphia, Pa.)
(Retina)
Vol. 29
Issue 4
Pg. 464-72
(Apr 2009)
ISSN: 1539-2864 [Electronic] United States |
PMID | 19289987
(Publication Type: Journal Article)
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Topics |
- Adult
- Aged
- Aged, 80 and over
- Diabetic Retinopathy
(surgery)
- Epiretinal Membrane
(surgery)
- Exudates and Transudates
(metabolism)
- Female
- Follow-Up Studies
- Glaucoma
(etiology)
- Glaucoma, Neovascular
(etiology)
- Humans
- Lens Implantation, Intraocular
- Macula Lutea
(metabolism)
- Macular Edema
(surgery)
- Male
- Middle Aged
- Phacoemulsification
- Postoperative Complications
- Postoperative Period
- Recurrence
- Retrospective Studies
- Treatment Outcome
- Visual Acuity
- Vitrectomy
(methods)
- Vitreous Hemorrhage
(etiology)
- Young Adult
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