Evaluating adjunctive surgical procedures during vitrectomy for diabetic macular edema.
OBJECTIVE
To evaluate the long-term outcomes of adjunctive surgical procedures during pars plana vitrectomy (PPV) for the treatment of diabetic macular edema (DME).


METHODS
In this nonrandomized study, we retrospectively analyzed 57 eyes of 54 patients who had DME and had undergone PPV. We performed PPV using three different surgical procedures: conventional PPV (group PVD; 13 eyes), triamcinolone acetonide (TA)-assisted PPV (group TA; 22 eyes), and TA-assisted PPV combined with internal limiting membrane (ILM) peeling (group ILM; 22 eyes). We also evaluated the preoperative and postoperative best-corrected visual acuity (BCVA) results.


RESULTS
The overall mean preoperative BCVA was 0.86 logarithm of the minimal angle of resolution unit. In groups PVD, TA, and ILM, BCVAs were 0.99, 0.90, and 0.74 (P = 0.310), respectively. The mean postoperative BCVA for all patients improved to 0.68 (P = 0.005). The postoperative BCVA improved in 47% of the treated eyes, it remained unchanged in 37% of the treated eyes, and it deteriorated in 16% of the treated eyes. However, we observed no significant difference in the mean postoperative BCVAs between the three groups. Furthermore, we found that there was no significant difference in postoperative BCVA improvements between any of the groups (P = 0.450).


CONCLUSIONS
The present study suggests that these 3 PPV approaches do not significantly affect postoperative BCVAs after 18 months of DME treatment.
Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
Yasutaka
Y
Mochizuki
Yasuaki
Y
Hata
Hiroshi
H
Enaida
Keizo
K
Yoshiyama
Miho
M
Miyazaki
Akifumi
A
Ueno
Toshinori
T
Murata
Taiji
T
Sakamoto
Toshiaki
T
Kubota
Tatsuro
T
Ishibashi
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001485:Basement Membrane / Q000601:surgery; D016022:Case-Control Studies; D003131:Combined Modality Therapy; D003930:Diabetic Retinopathy / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D019773:Epiretinal Membrane / Q000601:surgery*; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D008269:Macular Edema / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D014222:Triamcinolone Acetonide / Q000627:therapeutic use*; D014792:Visual Acuity; D014821:Vitrectomy / Q000379:methods*
D005938:Glucocorticoids; D014222:Triamcinolone Acetonide