Surgical management of macular edema

Macular edema, often a component of diabetic retinopathy, can be complicated by many other diseases. It is considered to be multifactorial and difficult to treat. The relation of the vitreous and macular edema is discussed. We examined many eyes of patients with diabetic macular edema that improved after spontaneous posterior vitreous detachment or vitrectomy for proliferative diabetic retinopathy. Recent advances in vitreous surgery have enabled us to treat surgically eyes with good visual acuity. We began surgical treatment for macular edema without the fibrous membrane in 1990. Here we discuss our experience in surgical treatment of macular edema as contrasted to photocoagulation therapy. This review is based on the published and unpublished results of our cases of more than 100 eyes that underwent vitrectomy for diabetic macular edema.