Combination of vitrectomy, IVTA, and laser photocoagulation for diabetic macular edema unresponsive to prior treatments; 3-year results.

Abstract

PURPOSE:

To evaluate the long-term effects of combined therapy of vitrectomy, intravitreal triamcinolone, and macular laser photocoagulation on diabetic macular edema (DME) unresponsive to prior treatment.

METHODS:

Medical records of 46 eyes of 41 subjects who underwent sequential combined therapy consisting of vitrectomy, intravitreal triamcinolone, and macular laser photocoagulation for refractory DME of non-tractional origin were reviewed. Best-corrected visual acuity (BCVA), central subfield thickness (CST) of macula, and number of additional treatments were analyzed.

RESULTS:

Forty eyes of 35 patients completed a 3-year follow-up. The mean (± SD) CSTs before and 6 months, 1 year, 2 years, and 3 years after the administration of combined therapy in these eyes were 499.1 ± 174.9, 224.2 ± 110.2, 273.4 ± 173.5, 237.5 ± 84.2 and 219.4 ± 66.6 µm, respectively (p < 0.001). The mean (± SD) logMAR BCVA before and 6 months, 1 year, 2 years, and 3 years after the combined therapy were 0.82 ± 0.32, 0.69 ± 0.40, 0.63 ± 0.39, 0.61 ± 0.46, and 0.55 ± 0.44, respectively (p < 0.001). Thirty-one of 40 eyes (77.5%) exhibited no recurrence of DME after the combined therapy. No visually significant complications other than progression of lens opacity and elevation of intraocular pressure were noted during the study period.

CONCLUSIONS:

This study demonstrated the long-term stability and efficacy of the combined therapy described herein for the treatment of refractory DME.

• Authors: Yun Taek Kim, Se Woong Kang, Sang Jin Kim, Sung Min Kim, Song Ee Chung
• Journal: Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie (Graefes Arch Clin Exp Ophthalmol) Vol. 250 Issue 5 Pg. 679-84 (May 2012) ISSN: 1435-702X [Electronic] Germany
• PMID: 22160508 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Glucocorticoids
• Triamcinolone Acetonide

Topics

• Combined Modality Therapy
• Diabetic Retinopathy (drug therapy, surgery, therapy)
• Female
• Follow-Up Studies
• Glucocorticoids (administration & dosage)
• Humans
• Intravitreal Injections
• Laser Coagulation
• Macular Edema (drug therapy, surgery, therapy)
• Male
• Middle Aged
• Treatment Outcome
• Triamcinolone Acetonide (administration & dosage)
• Visual Acuity (physiology)
• Vitrectomy