Pars plana vitrectomy for refractory diabetic macular edema

Abstract

Objective: The aim of this study is to describe the results of pars plana vitrectomy (PPV) for refractory diabetic macular edema (DME).

Methods: Review of the relevant peer-reviewed scientific literature identified using Medline.

Main outcome measures: The anatomical and functional outcome of surgery.

Results: Vitrectomy with or without internal limiting membrane (ILM) peeling can be beneficial for the treatment of DME that is resistant to laser photocoagulation or sub-Tenon's steroid injection. Visual improvement has been reported in approximately 40-90% of patients, with approximately 85-100% experiencing either improvement or stabilization of vision. Retinal edema decreases or resolves in approximately 70-100% of patients. Complications range in severity with approximately 5-20% of patients developing peripheral retinal breaks, approximately 1-2% developing retinal detachment, approximately 2% developing macular hole, and approximately 10-60% developing cataract. Severe complications such as rubeosis iridis and the fibrinoid syndrome have also been reported.

Conclusion: Pars plana vitrectomy can be an effective treatment for diabetic macular edema refractory to laser therapy and/or sub-Tenon's capsule steroid injection.