2M.D. Professor, Special Kariyer Eye Hospital, Isparta/TURKEY Purpose: To investigate the efficacy and safety of vitrectomy with triamcinolone acetonide (IVTA) injection followed by laser photocoagulation (LP) for diabetic macular edema (DME) refractory to anti-'vascular endothelial growth factor' (VEGF).
Materials and Methods: Eleven eyes of 11 patients with DME refractory to anti-VEGF treatment. Patients underwent combined vitrectomy, internal limiting membrane (ILM) peeling with IVTA (4 mg) and 1 month later followed by argon LP. Corrected visual acuity (CVA), intraocular pressure (IOP) and central macular thickness (CMT) were measured and compared at baseline and one, three, and six months (respectively) after vitrectomy.
Results: Eleven eyes of 11 patients [5(46.15%) male, 6(53.85%) female] with a mean age of 62.0±4.85 years (59-72 years) were included in this study. The mean IOP were 17.73±1.10 mmHg; 19.09±1.87 mmHg (p=0.015) and 19.73±1.68 mm Hg (p=0.006) respectively. The mean CMTs were 506.64±73.81 microns, 437.64±63.64 microns, 389.92±63.75 microns and 358.09±54.35 microns respectively (p=0.003). The mean CVAs (Log MAR) were 2.21±0.52 LogMAR, 1.77±0.63 LogMAR, 1.34±0.68 LogMAR, and 1.34±0.81, respectively. The values of both BCVA and CMT at one, three, and six months were significantly improved from baseline (p=0.003).
Conclusions: In our study, combined vitrectomy with IVTA and followed by LP is found to be safe and effective for DME refractory to anti-VEGF therapy. Further studies are needed for more information
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