Vitrectomy for diabetic cystoid macular edema

PURPOSE: We evaluated visual outcomes following vitrectomy for diabetic cystoid macular edema. METHODS: Visual outcomes and factors possibly influencing final visual acuity were assessed and documented retrospectively in 45 eyes of 40 patients, all of whom were followed up for at least 6 months postoperatively. RESULTS: Compared with the preoperative logarithm of the minimum angle of resolution (logMAR) visual acuity, final logMAR visual acuity improved 0.2 or more in 51% of the eyes, was unchanged in 47%, and decreased 0.2 or more in 2%. A final postoperative visual acuity of 0.5 or better was achieved in 38%. Preoperative visual acuity and the extent of the cystoid space on fluorescein angiography were significantly related to final visual acuity. A final postoperative visual acuity of 0.5 or better was noted in 8% of eyes with a preoperative visual acuity below 0.1, in 50% of eyes with a preoperative visual acuity of 0.1 or better, in 71% of eyes with a cystoid space smaller than 5 disc areas, and in 20% of eyes with a cystoid space of 5 disc areas or more. The state of the posterior vitreous membrane did not influence final visual acuity. There were no complications that decreased visual acuity. CONCLUSIONS: We conclude that diabetic cystoid macular edema is a good indication for vitrectomy, regardless of the state of the posterior vitreous membrane. A preoperative visual acuity of 0.1 or better and/or a cystoid space smaller than 5 disc areas may be indications for surgery aimed at achieving a final postoperative visual acuity of 0.5 or better.