Influence of pars plana vitrectomy in macular sensitivity, fixation stability and retinal morphology in patients with refractory diabetic macular edema . Noce J,1 Salomone M,2 Di Crescenzo C,2 Valente S,2. 1 2
Ospedale “S.M.Goretti”-Latina.
Università degli studi di Roma “Sapienza”-Polo Pontino, Ospedale “A.Fiorini” Terracina.
ABSTRACT Purpose: morphological and functional assessment of 23 G pars plana vitrectomy in patients with non- tractive refractory diabetic macular edema.
Materials and Methods: 19 eyes of 19 patients ( 12 males , 7 females , 56 ± 7.5 years ) underwent pars plana vitrectomy in 23 -gauge . The patients underwent complete eye examination with determination of visual acuity using the Snellen optotype . The Central Macular Thickness (CMT ) has been obtained with optical coherence tomography ( OCT Spectralis , Heidelberg Engineering , Heidelberg , Germany) , the study of fixation and retinal sensitivity was performed with microperimeter MP -1 ( version 1.7.6 software , Nidek Technologies, Japan). The data were analyzed at baseline and 12 weeks after surgery, and were subsequently treated with biofeedback rehabilitation ( 10 sessions from 10 minutes ) .
Results: To a functional point, after vitrectomy, there was a significant improvement in both sensitivity retinal (P < 0.001) in the bivariate contour ellipse area ( P = 0.006 ) . In addition a significant morphological improvement in mean retinal thickness after vitrectomy ( P = 0.04 ) was shown. At the end of rehabilitative treatment retinal sensitivity remained unchanged ( P = 0.18), while the BCEA is further improved significantly ( P = 0.03 ) .
Conclusions: The 23 gauge pars plana vitrectomy is also useful in patients with non-tractive macular edema from both the functional and morphological point. The rehabilitative treatment has proved useful to improve the stability of fixation in these patients, as a complementary treatment to surgery.