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

Long-term Results of a Comparative Study

Bonnin, Sophie MD*; Sandali, Otman MD*; Bonnel, Sébastien MD*; Monin, Claire MD*; El Sanharawi, Mohamed MD*,†

doi: 10.1097/IAE.0000000000000433
Original Study
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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.

*Department of Ophthalmology, Quinze-Vingts National Ophthalmology Hospital, Paris, France; and

National Institute of Health and Medical Research, Cordeliers Research Center, Physiopathology of Ocular Diseases: Therapeutic Innovations, Pierre and Marie Curie University, Paris, France.

Reprint requests: Sophie Bonnin, MD, Service d'Ophtalmologie, Center Hospitalier National d'Ophtalmologie des Quinze-Vingts, 28 Rue de Charenton, 75571 Paris, Cedex 12, France; e-mail: soph.bonnin@gmail.com

Supported by Pierre et Marie Curie University, Paris 6, Paris, France.

None of the authors have any conflicting interests to disclose.

© 2015 by Ophthalmic Communications Society, Inc.