Vitrectomy combined with phacoemulsification and intraocular lens implantation for diabetic macular edema

PURPOSE: The outcome of vitrectomy combined with phacoemulsification and intraocular lens implantation (PEA+IOL) for diabetic macular edema was evaluated. METHODS: Included in this study were 31 patients (42 eyes) with clinically significant diabetic macular edema, in whom posterior vitreous detachment was not observed. Pars plana vitrectomy combined with PEA+IOL was performed on 15 eyes. Sixteen phakic eyes and 11 pseudophakic eyes were followed up without vitrectomy as controls. Visual acuity and the state of macular edema were evaluated. RESULTS: After follow-up of 18 +/- 7 (mean +/- SD) months, clinically significant macular edema remained in 3 eyes (20%) of the vitrectomy group, in 11 eyes (69%) of the phakic control group, and in 9 eyes (82%) of the pseudophakic control group. The logarithm of the minimal angle of resolution (Log(MAR)) of the best-corrected visual acuity of the vitrectomy group eyes significantly improved from 1.09 +/- 0.27 to 0.80 +/- 0.35 (P <.01), while that of pseudophakic control eyes significantly decreased from 0.59 +/- 0.17 to 0.86 +/- 0.28 (P <.05). The Log(MAR) of phakic control eyes also decreased from 0.82 +/- 0.36 to 0.93 +/- 0.30, but there was no significant difference (P =.19). CONCLUSION: Vitrectomy combined with PEA+IOL is an effective surgical modality to improve visual acuity in eyes with clinically significant diabetic macular edema.