Long-term follow-up of vitrectomy for diffuse nontractional diabetic macular edema.

Abstract

PURPOSE:

To report the long-term results of pars plana vitrectomy for diffuse nontractional diabetic macular edema.

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.

• 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)

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