Retina. 29(4):464-472, APR 2009
DOI: 10.1097/IAE.0b013e31819c632f
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PMID: 19289987
Issn Print: 0275-004X
Publication Date: 2009/04/01
LONG-TERM FOLLOW-UP OF VITRECTOMY FOR DIFFUSE NONTRACTIONAL DIABETIC MACULAR EDEMA
KAZUYUKI KUMAGAI;MARIKO FURUKAWA;NOBUCHIKA OGINO;ERIC LARSON;MASAYOSHI IWAKI;NAOKO TACHI;
+ Author Information
From the *Shinjo Ophthalmologic Institute, Miyazaki; †Department of Ophthalmology, Kami-iida First General Hospital, Nagoya; ‡Miyazaki Prefectural Nursing University, Miyazaki; §Department of Ophthalmology, Aichi Medical University, Nagakute-cho, Aichi; and ¶Department of Ophthalmology, Shinseikai Toyama Hopital, Imizu-shi, Japan.
Abstract
To report the long-term results of pars plana vitrectomy for diffuse nontractional diabetic macular edema.Interventional, retrospective, consecutive case series.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.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%).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.
