Vitrectomy for diabetic cystoid macular edema

PURPOSE: We evaluated the visual outcome of vitrectomy for diabetic cystoid macular edema. METHODS: Visual outcome and factors which may influence final visual acuity were assessed and documented retrospectively in 45 eyes of 40 patients, all of whom were followed for at least 6 months postoperatively. RESULTS: Final postoperative visual acuity was two or more lines better than preoperative visual acuity in 58%, within one line in 40%, and had decreased by two lines 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 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 posterior vitreous membrane condition did not influence final visual acuity. There were no complications which decreased visual acuity. CONCLUSION: Based on the above results, we conclude that diabetic cystoid macular edema is a good indication for vitrectomy regardless of the posterior vitreous membrane condition. 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.