Long-term follow-up of vitrectomy for diffuse nontractional diabetic macular edema.
OBJECTIVE
To report the long-term results of pars plana vitrectomy for diffuse nontractional diabetic macular edema.


METHODS
Interventional, retrospective, consecutive case series.


METHODS
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.


RESULTS
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%).


CONCLUSIONS
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.
Kumagai
Kazuyuki
K
Shinjo Ophthalmologic Institute, Miyazaki, Japan. ganka@kamiiida-hp.jp
Furukawa
Mariko
M
Ogino
Nobuchika
N
Larson
Eric
E
Iwaki
Masayoshi
M
Tachi
Naoko
N
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003930:Diabetic Retinopathy / Q000601:surgery*; D019773:Epiretinal Membrane / Q000601:surgery; D005122:Exudates and Transudates / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D005901:Glaucoma / Q000209:etiology; D015355:Glaucoma, Neovascular / Q000209:etiology; D006801:Humans; D019654:Lens Implantation, Intraocular; D008266:Macula Lutea / Q000378:metabolism; D008269:Macular Edema / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification; D011183:Postoperative Complications; D011184:Postoperative Period; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity; D014821:Vitrectomy / Q000379:methods; D014823:Vitreous Hemorrhage / Q000209:etiology; D055815:Young Adult