Visual Outcome and Complications of Vitrectomy for Diabetic Macular Edema at One-Year Follow-up / 国际眼科杂志(Guoji Yanke Zazhi)

ABSTRACT

AIM: To evaluate the surgical efficacy of vitrectomy for diabetic macular edema (DME) at one year's follow-up.METHODS: The surgical outcomes in 116 consecutive eyes of 89 patients who had vitrectomy for diabetic macular edema were retrospectively reviewed and analyzed. All the patients were followed up for one year or longer postoperatively.RESULTS: The one year postoperative mean best-corrected visual acuity (BCVA) (0.428± 0.387) was significantly better than the mean preoperative BCVA (0.285±0.249;Wilcoxon signed-rank test, P＜0.0001). In 41 eyes with nonproliferative diabetic retinopathy (NPDR), mean BCVA improved significantly from 0.291± 0.201 preoperatively to 0.45± 0.41 at one year of follow-up (Wilcoxon signed-rank test, P=0.0171). In 75 eyes with proliferative diabetic retinopathy (PDR), mean BCVA improved significantly from 0.282± 0.272 preoperatively to 0.416± 0.376at one year of follow-up (Wilcoxon signed-rank test, P＜0.0001). The stage of diabetic retinopathy did not influence final visual acuity. Macular edema resolved in 74 of 116 eyes (63.8%) after the surgery. BCVA improved by 2 or more lines in 53 eyes (45.7%), remained unchanged in 39 eyes (33.6%), and exacerbated by 2 or more lines after the surgery in 24 eyes (20.7%). The intraoperative and postoperative complications included iatrogenic retinal tears (9 eyes), vitreous hemorrhage (10 eyes), neovascular glaucoma (6 eyes), hard exudates deposition in the center of macula (18 eyes), macular atrophy (19 eyes) and epiretinal membrane (3 eyes). Among these complications,exacerbation of BCVA by 2 or more lines occurred due to neovascular glaucoma (4 eyes), macular atrophy (10 eyes), hard exudates deposition (9 eyes) and epiretinal membrane (1 eyes).CONCLUSIONS: Vitrectomy is an effective procedure for improving visual acuity and reducing macular edema in eyes with DME. However, careful preoperative examinations and adequate surgical techniques are imperative to avoid severe complications of this treatment.