Abstract
Objective : To evaluate the long-term efficacy of vitrectomy for diabetic macular edema.
Materials and Methods : Between February 1999 and August 2005, we performed vitrectomy on 75 eyes of 50 cases with diffuse-type diabetic macular edema. Vitreous detachment was absent in all cases. All cases were followed up for more than one year. Visual acuity, foveal retinal thickness, and the status of hard exudates deposits were evaluated before and after operations. In addition, the relationship between HbA1c and renal function and visual outcome were examined.
Results : Visual acuity improved by two lines or more in 36 eyes (49.3 %), remained unchanged in 20 eyes (27.4 %), and deteriorated in 17 eyes (23.3 %). A significant improvement was observed three months after the operation (p < 0.05), and improved visual acuity remained until one year after treatment. Retinal thickness started to improve from one month after the operation, and showed a continual decrease in thickness (p < 0.01). Foveal hard exudates were observed in 40 eyes (54.8 %) before the operation. Although the amount of hard exudates increased after the operation, such a phenomenon disappeared in 67 % of the better visual outcome group, 22 % in the unchanged group, and 30 % in the deteriorated group.
The reasons for deteriorated visual acuity were deposits of hard exudates in 8 eyes, remaining edema in 4 eyes, macular atrophy in 3 eyes, and optic nerve atrophy caused by neovascular glaucoma in 2 eyes. There were no significant relationships between HbA1c, renal function, and visual acuity changes.
Conclusions : Vitrectomy can be considered effective for the long-term treatment of diffusetype diabetic macular edema without posterior vitreous detachment.
