Clinically significant diabetic macular oedema (CSME): pars plana vitrectomy or laser coagulation?


SYNEK Svatopluk SYNKOVÁ Monika PÁČ Libor

Year of publication 2007
Type Article in Proceedings
Conference Supplement European Journal of Ophthalomology
MU Faculty or unit

Faculty of Medicine

Field ORL, ophthalmology, stomatology
Keywords Diabetic macular oedema; pars plana vitrectomy; laser coagulation
Description Purpose: compare results of PPV with peeling ILM to classical laser coagulation Method: 20 patients with CSME were randomizing into two groups. Group one was treated by pars plana vitrectomy with peeling of ILM, group two was treated by focal and panretinal laser coagulation. The anatomical healing was proofed by slit lamp biomicroscopy and OCT examination. Exclusion criteria were previous PPV, epiretinal membrane or proliferative diabetic retinopathy, hard exudates, previous laser therapy, glaucoma and intravitreal injection of triamcinolon or antiVEGF agent. Examinations were done in 1 month, 3 month and 1 year. Results: Median duration of CSME at the time of PPV was approximately 11.0 months. The median preoperative best-corrected VA of 0.08, improved to a median postoperative VA of 0.25. 10 eyes without preoperative laser coagulation had a median VA improvement of 77%, while 10 eyes with preoperative macular laser treatment had a median VA improvement of 14.8%. In all 20 eyes, CSME was no longer visible on microscopic examination after a median period of 3.0 months after PPV. Macula was healing in all cases. The patients with ILM peeling have a prolonged healing period but the finish visual acuity was better. Conclusion: Results of PPV in CSME are promising. A randomized controlled prospective trial of PPV versus laser is needed to determine the role of PPV as treatment modality for CSME.
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