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[Persistent diabetic macular edema--surgical versus laser therapy].
D Brănişteanu1, M Robu, A Irimia
1Clinica I Oftalmologie - Universitatea dE Medicină şi Farmacie GR. T. Popa, Iaşi, România.
Oftalmologia (Bucharest, Romania : 1990)
|July 4, 2007
Summary
Pars plana vitrectomy with internal limiting membrane (ILM) peeling effectively treats persistent diabetic macular edema, significantly improving vision compared to laser therapy. Previous laser treatments may limit visual gains from vitrectomy.
Area of Science:
- Ophthalmology
- Retinal Diseases
- Surgical Interventions
Background:
- Diabetic macular edema (DME) is a leading cause of vision loss in diabetic patients.
- Persistent DME often requires advanced treatment strategies.
- Conventional laser therapy has limitations in managing refractory cases.
Observation:
- This study prospectively evaluated 22 eyes with persistent DME.
- Pars plana vitrectomy with internal limiting membrane (ILM) peeling was compared to continued laser photocoagulation.
- Eyes with taut posterior hyaloid or epiretinal membranes were excluded.
Findings:
- Macular edema resolved in 72.7% of vitrectomized eyes versus 18.2% of laser-treated eyes.
- Visual acuity improved in 45.45% of vitrectomized eyes compared to 9.09% of control eyes.
- Significant visual improvement was observed in vitrectomized eyes with fewer than 3 prior laser treatments.
Implications:
- Pars plana vitrectomy with ILM peeling is a viable and effective treatment for persistent DME.
- The number of prior laser sessions may influence the functional outcomes of vitrectomy.
- Further research may explore optimal timing and patient selection for vitrectomy in DME management.
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