VITRECTOMY WITH INTERNAL LIMITING MEMBRANE PEELING FOR TRACTIONAL AND NONTRACTIONAL DIABETIC MACULAR EDEMA

Abstract

In Brief Purpose: To compare the long-term outcomes of vitreomacular surgery in eyes with nontractional diabetic macular edema (DME) with those from eyes with tractional DME. Methods: Retrospective comparative study from 55 consecutive patients (73 eyes). Twenty eyes were operated on for tractional DME and 53 eyes for nontractional DME unresponsive to laser photocoagulation or triamcinolone intravitreal injections. The best-corrected visual acuity, the central macular thickness, and the surgical complications were analyzed. Results: The mean follow-up duration was 5.3 ± 2.4 years for the group with traction and 4.4 ± 1.7 years for the group without traction (P = 0.13). At 3 years, the mean logarithm of the minimum angle of resolution best-corrected visual acuity had improved significantly from 0.78 to 0.58 for the group without traction and from 0.75 to 0.45 for the group with traction (P < 0.001). At the final visit, there was no significant difference between the 2 groups in regard to visual or central macular thickness improvement (P = 0.447 and P = 0.742, respectively). The incidence of surgical complications was not significant between the two groups. The preoperative best-corrected visual acuity was the only predictive factor for the final best-corrected visual acuity. Conclusion: The results of vitrectomy were not different in terms of anatomical and visual outcomes and surgical complications between eyes without tractional DME and eyes with tractional DME. Numerous patients with diabetic macular edema are nonresponder to anti-vascular endothelial growth factor therapy, justifying studies about alternative treatments in this disease. Long-term outcomes of vitreomacular surgery in eyes with nontractional diabetic macular edema and eyes with tractional diabetic macular edema were not different in terms of anatomical and visual outcomes and surgical complications.