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Central vision often improved after vitrectomy in patients with diabetic macular edema
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In patients with diabetic macular edema, pars plana vitrectomy “almost always” resulted in a reduction or disappearance of the edema, a group of German researchers reported. More important, they noted, vitrectomy often resulted in an improvement in central visual acuity and in patients’ quality of life.
Claus E. Jahn and colleagues in Ulm conducted a prospective study to determine the usefulness of pars plana vitrectomy in resolving diabetic macular edema and halting the deterioration of central visual acuity. Vitrectomy was performed in 30 eyes of 21 patients with type 2 diabetes and diabetic macular edema. Patients had a median age of 71 years, with a range of 61 years to 88 years. Twenty-three eyes had nonproliferative diabetic retinopathy, and seven had proliferative diabetic retinopathy in addition to the macular edema.
Posterior vitreous detachment had to be performed in all cases, the study authors said. In 23 eyes in which epithelial membranes were present, they were removed during surgery. Thirteen eyes had the internal limiting membrane removed as well. The median follow-up was 16 months, ranging from 1 to 62 months.
In 74% of the eyes, the macula was flattened or reattached after vitrectomy. During fluorescein angiography, 15 of 18 eyes showed a reduction or disappearance of leakage. Central visual acuity increased by 2 to 6 lines in 15 of the 27 eyes by 6 months postoperatively.
The study is published in the November/December issue of Ophthalmologica.