gms | German Medical Science

102. Jahrestagung der DOG

Deutsche Ophthalmologische Gesellschaft e. V.

23. bis 26.09.2004, Berlin

Pars-plana vitrectomy in the treatment of diabetic macular edema

Meeting Abstract

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  • corresponding author P. Nemec - Department of Ophthalmology, Central Military Hospital, Prague, Czech Rep.
  • J. Ernest - Department of Ophthalmology, Central Military Hospital, Prague, Czech Rep.
  • L. Rejmont - Department of Ophthalmology, Central Military Hospital, Prague, Czech Rep.
  • R. Svoboda - Department of Ophthalmology, Central Military Hospital, Prague, Czech Rep.

Evidenzbasierte Medizin - Anspruch und Wirklichkeit. 102. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft. Berlin, 23.-26.09.2004. Düsseldorf, Köln: German Medical Science; 2004. Doc04dogSA.08.02

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Veröffentlicht: 22. September 2004

© 2004 Nemec et al.
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To present vitrectomy as an effective therapeutic procedure in diabetic diffuse macular edema. The determination of which eyes might benefit from vitrectomy is the most challenging aspect in the treatment of this condition.


In addition to general and local vascular alterations, vitreomacular traction has been considered for a decade as a provocative factor of the diabetic macular edema. Strict control of basic disease, or laser coagulation therapy reduces macular edema in most of the eyes. In otherwise therapy resistant cases vitrectomy offers a new technique, that may be beneficial in some eyes.

Patients and methods

Twenty-five eyes of 20 patients had been operated on because of diabetic macular edema. In 10 eyes cataract extraction was performed. Fluorescein angiography, B-scan untrasonography, visual acuity exam, and optical coherence tomography were performed before surgery and 3rd, 6th, and 12th months after surgery.


Out of the total of 25 eyes, in 18 eyes (72%) macular edema diminished or disappeared after surgery, in 7 remained unchanged or worse. Visual acuity improvement (1-3 Snellen lines) was observed in 21 eyes. In 4 eyes VA-deterioration was detected. Early postoperative complications included 2 mild vitreous hemorrhages. Cataract as a late postoperative complication was observed and has been operated on in 8 cases.


Vitreoretinal traction is now considered as causative factor in the development of diabetic macular edema. Vitrectomy offers a useful way in the treatment of some diabetic maculopathy. Visual improvement as well as anatomical conditions of macular region after vitrectomy is related to the duration of edema, as well as the extent of intraretinal lipid and vascular nonperfusion.