| Abstract
Purpose: 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 with diabetic macular edema were retrospectively analyzed, all of whom were followed up for one year or more postoperatively.
Results: The one year postoperative mean best-corrected visual acuity (BCVA) (0.428±0.387〔mean±SD〕) 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 0.450±0.410 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±0.376 at 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 iatragenic 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 was an effective procedure for improving visual acuity and reducing the edema in eyes with DME, regardless of the stage of diabetic retinopathy. However, careful examinations and surgical techniques are necessary because there are severe complications of this treatment.
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