白内障超声乳化术后黄斑部的光学相干断层扫描

目的观察白内障顺利进行超声乳化术后黄斑部的变化。方法应用光学相干断层扫描仪分析50眼单纯年龄相关性白内障及33眼合并糖尿病或葡萄膜炎或高度近视的年龄相关性白内障超声乳化吸出术后2、4、6、8周及3个月的黄斑部变化及60只正常眼的黄斑部。结果正常人中心注视点厚度为(151.5±11.1)μm,白内障超声乳化术后中心注视点厚度增加,但单纯白内障组仅于术后4~6周有显著性差异;单纯白内障组10眼(20%)出现术后黄斑水肿,均发生于术后2~6周,包括8眼中心凹增厚及2眼黄斑囊样水肿,其中9眼(90%)于6个月内自愈;合并症组13眼(43.3%)出现术后黄斑水肿且消退缓慢;术后各期中心凹厚度与视力呈负相关。结论白内障超声乳化术后黄斑部呈现厚度增加的趋势,造成一定程度的视力下降,尤其是糖尿病、高度近视等易患黄斑水肿者,少数人会出现黄斑囊样水肿,但绝大多数人可自愈,预后良好。     

白内障超声乳化手术后黄斑区光学相干断层扫描

目的:观察白内障超声乳化吸除联合人工晶状体植入术后黄斑中心凹厚度的改变。方法:对行白内障超声乳化吸除联合人工晶状体植入术,且术前、术中无并发症患者56例56眼,行术前及术后1,3mo黄斑区OCT检查,观察术眼黄斑中心凹厚度变化及视力变化。结果:56眼黄斑中心凹视网膜平均厚度术前为241.3±9.9μm,术后1mo为(260.7±16.8)μm,术后3mo为(245.6±17.6)μm,术后1mo与术前比较,差异有显著性意义(P=0.000),术后3mo与术前比较,差异无显著性意义(P=0.137)。术后1mo,2眼出现黄斑囊样水肿,术后3mo,1眼黄斑囊样水肿消退,另1眼黄斑囊样水肿较前略降低,其余眼未出现黄斑囊样水肿。结论:白内障超声乳化吸除联合人工晶状体植入术后1mo黄斑中心凹厚度明显增加,术后3mo大部分黄斑水肿消退。     

芪明颗粒对糖尿病患者白内障超声乳化术后黄斑水肿的疗效观察

目的：探讨芪明颗粒对行白内障超声乳化吸除术的糖尿病患者术后黄斑水肿的预防效果。
　　方法：本研究采用临床对照研究。将行白内障超声乳化联合人工晶状体植入术的糖尿病患者分成两组,治疗组(34眼)术后1d始接受口服芪明颗粒4.5g,每日3次和维生素C片0.1g,每日3次治疗;对照组(42眼)接受维生素C片0.1g,每日3次。6mo后使用相干断层扫描仪(optical coherence tomography,OCT)检测黄斑囊样水肿的发病率和所有患者黄斑中心区视网膜厚度。
　　结果：OCT检查发现,治疗组黄斑囊样水肿2眼(6%),对照组黄斑囊样水肿6眼(14%),差异无统计学意义(P=0.285);治疗组黄斑中心凹视网膜厚度(211.76±41.21μm)显著低于对照组(278.36±48.94μm)(P<0.01) 。
　　结论：芪明颗粒有助于减少糖尿病患者白内障术后黄斑视网膜厚度的增加。     

老年性白内障超声乳化吸后囊环形撕开联合人工晶状体植入术临床观察

目的 观察老年性白内障超声乳化吸除后囊环形撕开联合人工晶状体植入术的临床疗效.方法 选取2010年1月至2010年4月在我院门诊和病房行老年性白内障超声乳化手术的患者30例(60只眼),均为双眼白内障患者,除外高血压、糖尿病、高度近视、晶状体脱位以及半脱位,青光眼以及囊膜剥脱的患者.年龄在52～90岁,男32例,女28例.患者一眼行后囊撕开、另一眼行不撕开手术,植入同种人工晶状体.手术后随访1年.结果 术后矫正视力0.1～0.3者10只眼,0.3～0.6者36只眼,0.6以上者14只眼,无视网膜脱离发生,黄斑囊样水肿患者为3.3%.两组无明显差异.所有术眼无人工晶状体脱位,轻度偏位的发生率为6%.结论 老年性白内障超声乳化手术后囊环形撕开联合人工晶状体植入,是一种安全有效的手术技术,可以有效防止后囊浑浊,远期手术并发症少,黄斑囊样水肿和视网膜脱离的发病率与常规白内障超声乳化手术无统计学差异.     

糖尿病患者白内障超声乳化吸出联合人工晶状体植入

目的　观察糖尿病患者行白内障超声乳化吸出联合人工晶状体植入术的临床效果。方法　对884 例1 079 眼患有糖尿病的白内障术后患者的视力及并发症进行分析,并选取同时期、同一手术医师施行的非糖尿病白内障患者做对照。手术采用巩膜隧道切口超声乳化及囊袋内人工晶状体植入法。术前空腹血糖控制在8.5 mmol·L-1以下。结果　糖尿病患者术后3 d矫正视力与非糖尿病患者相比无明显差异(P>0 05),<0.5者454眼,均为眼底出血、渗出累及黄斑及黄斑囊样水肿、增殖性视网膜病变所致。糖尿病患者术前瞳孔不能充分散大或术中瞳孔缩小、瞳孔缘损伤和术后角膜水肿、黄斑水肿的病例明显多于非糖尿病患者。结论　糖尿病患者行白内障超声乳化吸出联合人工晶状体植入术,可明显改善视力,超声乳化吸出术治疗糖尿病患者白内障是安全有效的,并为糖尿病视网膜病变的荧光血管造影和激光治疗提供了条件。眼底出血、渗出累及黄斑、黄斑囊样水肿、增殖性糖尿病视网膜病变是影响术后视力的主要因素。     

后房型人工晶体植入与单纯白内障囊外摘除术的并发症比较

分析314只眼白内障囊外摘除手术,其中168只眼同时植入后房型人工晶体,146只眼为单纯白内障囊外摘除.比较两组并发症和视力,结果表明人工晶体手术组的并发症发生率较低,术中玻璃体溢出为2.38%,黄斑囊样水肿的发生率为0.6%.术后矫正视力达0.5以上者97.62%.而单纯囊外摘除组却有较高的并发症和较差的术后视力.眼科学报 1993;9:90-92.     

前部玻璃体切割术处理玻璃体脱出

作者对57例(59眼)白内障手术中有玻璃体脱出经前部玻璃体切割处理的病人进行了长期随访。平均随访时间为26个月。病人平均年龄60岁。53眼(90%)白内障囊内或囊外摘出术,6眼(10%)白内障乳化取出术。37眼(63%)用自动玻璃体切割器切割,22眼(37%)用纤维素海绵切割。除全面眼部检查外,视力低于20/40者,作了眼底荧光血管造影。术后最好视力和最后视力,两种切割方法间无明显差异(P>0.05)。最后视力低于20/40者主要是因慢性或短暂的黄斑囊性水肿。但两种切割术的黄斑囊性水肿发生率相同。前部玻璃体切割术后,症状性黄斑囊性水肿的发病率为28～42%。     

合并糖尿病眼底病变患者白内障术后的黄斑水肿和视力观察

目的:探讨合并糖尿病眼底病变患者白内障术后与正常眼底的患者白内障术后的黄斑水肿和视力恢复情况。方法:选取63例63眼白内障患者,其中33例伴有轻至中度糖尿病眼底改变,为糖尿病组;另外30例正常眼底为对照组。相同的术式、手术医生及术后处理。于术前、术后1,6wk及6mo检查视力及眼底情况,于术前、术后6wk行荧光素眼底血管造影检查,观察两组术后黄斑水肿及视力恢复情况。结果:糖尿病患者32例及对照组29例患者完成检查并随访。术后6wk,糖尿病组有24例(75%)出现眼底渗漏,而对照组只有6例(21%);糖尿病组有5例(16%)出现临床型黄斑囊样水肿(CME),对照组有2例(7%)出现临床型CME;术后6mo,两组视力水平差异无显著性,黄斑水肿恢复。结论:白内障术后不管是对正常眼底还是对伴轻中度糖尿病视网膜病变都可发生CME,但视力恢复无明显差异,发生CME予随诊,一般不需处理,多能自行恢复。     

后囊连续环形撕囊联合前部玻璃体切割术治疗先天性白内障的疗效观察

目的 探讨后囊连续环形撕囊联合前部玻璃体切割术治疗儿童白内障术后后发性白内障的疗效.方法 选取先天性白内障患儿62例(68眼),超声乳化后行后囊连续环形撕囊及前部玻璃体切割术,一期囊袋内植入人工晶状体,术后随访2 a以上,观察术后视力及后发性白内障发生情况.结果 68眼中有5眼在术后3个月至2 a出现后发性白内障,占7.35%,平均出现时间为16个月.术后2～3个月复查矫正视力,0.2～0.4者17眼,0.5～O.7者28眼,≥0.8者20眼;手术前后视力比较,差异有统计学意义(P<0.05).后发性白内障发生率经年龄分组比较,差异无统计学意义(P>0.05).所有惠儿均未发生黄斑囊样水肿或视网膜脱离等并发症.结论 后囊连续环形撕囊联合前部玻璃体切割术是预防后发性白内障发生较为有效的方法.     

活血化淤汤对超声乳化白内障吸除术后黄斑区的保护作用

目的:探讨活血化淤汤对超声乳化白内障吸除术后黄斑区的保护作用。方法:单纯年龄相关性白内障患者130例140眼分为A,B两组,A组80眼常规超声乳化吸除术;B组60眼行超声乳化吸除术后给予活血化瘀汤口服两个疗程,A,B两组分别于术前、术后1d;1,2,4,6,8wk及3mo观察最佳矫正视力、角膜及房水情况、黄斑中心凹视网膜厚度及黄斑区组织变化情况。结果:术后3mo,B组视力≥1.0的比例明显高于A组,差别有统计学意义。术后1wk,B组房水轻度闪辉比例明显低于A组,差别有统计学意义。术后1,2,4,6,8wk;3mo白内障超声乳化术后出现中心注视点厚度增加,A,B两组术后2～8wk与术前比较差异均有统计学意义;其中A组11眼(13.7%)出现术后黄斑水肿,均发生于术后2～6wk,包括9眼中心凹增厚及2眼黄斑囊样水肿,其中7眼3mo内水肿消失;B组2眼(3.3%)出现术后黄斑水肿,包括1眼中心凹增厚及1眼黄斑囊样水肿,发生于术后4～6wk,到术后3mo水肿消失。术后2～8wk,B组中心凹厚度低于A组,差异有统计学意义。结论:白内障超声乳化术后黄斑部呈现厚度增加的趋势,造成一定程度的视力下降,少数人会出现黄斑囊样水肿,术后口服中药活血化瘀汤后视力≥1.0的比例明显提高,黄斑中心凹的厚度及黄斑水肿的发生率大大降低,提示了活血化瘀汤对超声乳化白内障吸除术后黄斑区的保护作用。     

Visually significant cystoid macular edema in pseudophakic and aphakic patients with glaucoma receiving latanoprost

PURPOSE: To investigate the incidence of visually significant cystoid macular edema associated with the use of latanoprost in patients with glaucoma after cataract surgery. PATIENTS AND METHODS: This is a multicenter, retrospective study of 185 patients, of whom 173 were pseudophakic (212 eyes) and 12 were aphakic (13 eyes), who were treated for glaucoma with latanoprost 0.005%. The posterior lens capsule was intact in 125 eyes, open or absent as a result of surgery in 25 eyes, and status-post-yttrium-aluminum-garnet capsulotomy in 75 eyes. Visual acuity was documented before and after initiating latanoprost therapy, and patients with a reduction of two or more lines on the Snellen chart were examined by fluorescein angiography for cystoid macular edema. RESULTS: Visual reduction was documented in four (2.16%) patients. Three of the four patients had cystoid macular edema, and the fourth was thought to have lost a central island of vision from glaucoma. The three patients with cystoid macular edema all had ruptured posterior capsules, requiring anterior vitrectomy, and one had a previous episode of cystoid macular edema 3 years before starting latanoprost therapy. CONCLUSION: These findings suggest that visually significant cystoid macular edema associated with latanoprost therapy in pseudophakic or aphakic patients is uncommon. If there is a cause-and-effect relationship between latanoprost therapy and clinically significant cystoid macular edema, the incidence appears to be low.     

Ketorolac treatment of pseudophakic cystoid macular edema identified more than 24 months after cataract extraction.

OBJECTIVE: To evaluate whether ketorolac ophthalmic drops prescribed four times a day can be associated with improved visual acuity and prompt resolution of edema for patients with pseudophakic cystoid macular edema identified more than 24 months after cataract surgery. DESIGN: Prospective, nonrandomized, comparative (subject self-controlled) trial. PARTICIPANTS: The records of nine patients who had pseudophakic cystoid macular edema more than 24 months after cataract surgery at the time treatment commenced were identified at the Wilmer Retinal Vascular Center from September 1, 1996, through March 1, 1997. MAIN OUTCOME MEASURES: Best-corrected visual acuities measured on a retroilluminated Bailey-Lovie chart approximately every 3 months, contact lens biomicroscopy, and fluorescein angiography following ketorolac. INTERVENTION: Commercially available ketorolac ophthalmic drops 0.5% were prescribed for the affected eye four times a day for at least 3 months and continued until edema resolved. RESULTS: Ten eyes of nine patients were identified more than 24 months after cataract extraction (median, 59 months). Seven eyes (70%) improved (mean, +3.2 lines; range, +1 to +13 lines), including six by 2 or more lines 3 months after treatment initiation. Two eyes (20%) were unchanged, and one eye (10%) was 1 line worse. All seven eyes that improved 1 line or more had some or complete angiographic resolution of fluorescein dye leakage. In these seven eyes, ketorolac was discontinued when dye leakage completely resolved or failed to continue to improve on periodic 3-month follow-up examinations. In all seven eyes, recurrence of edema was noted within 3 months after ketorolac was stopped. CONCLUSIONS: Chronic pseudophakic cystoid macular edema identified more than 24 months after cataract surgery can improve with topical ketorolac but probably requires persistent use.     

Managing cystoid macular edema after cataract surgery

Cystoid macular edema (CME) is a common problem after cataract extraction. It can occur after uncomplicated surgery in patients with otherwise healthy eyes, after complicated surgery, or after surgery in patients with ocular diseases such as uveitis or diabetic retinopathy. Usually vision loss from cystoid macular edema is temporary and responds to treatment with topical anti-inflammatory medications. However, some cases respond poorly to conservative treatment and may develop permanent visual loss. A review of the medical literature was performed for all articles published in English between August 1, 2001 and July 31, 2002 on the topic of cystoid macular edema after cataract surgery. The authors selected nine articles that were most relevant to the practicing ophthalmologist for inclusion in this review. Topics of interest included vitreous loss, retained lens fragments, diabetes, uveitis, retinitis pigmentosa, ocular hypotensive lipids, internal limiting membrane peeling, and intravitreal triamcinolone injection.     

氟比洛芬对糖尿病白内障患者超声乳化术后黄斑囊样水肿预防作用的研究

目的探讨氟比洛芬对糖尿病（DM）白内障患者超声乳化术后黄斑囊样水肿（CME）的预防作用。方法选择2008年9月至2009年3月就诊并行超声乳化手术、临床资料完整的DM白内障患者（DM组）100例。同时,选取非DM白内障患者25例为研究的对照。将DM白内障患者随机分入四组。A组23例（27只眼）,典必殊滴眼液术后第1周6次/d,后3周4次/d;B组24例（30只眼）,0.03%氟比洛芬滴眼液和典必殊滴眼液术后第1周各4次/d,后3周各3次/d;C组27例（34只眼）,术前1d开始滴用0.03%氟比洛芬滴眼液,3次/d,术后用药及方法同B组;D组26例（36只眼）,术前7d开始滴用0.03%氟比洛芬滴眼液,3次/d,术后用药及方法同B组。非DM白内障患者采用A组的治疗方法,25例（32只眼）。所有患者于术后第1、3、7、14、30天和90天接受术眼症状或体征的综合评分。术前和术后的第30天、第90天,对患者进行视力和眼压的测定。患者分别于术前和术后第90天进行眼底的相干光断层成像（OCT）和荧光素眼底血管造影（FFA）检查。结果 DM白内障A组和B组术后CME发生率高于其它各组（P〈0.01）。术眼症状和体征综合评分,各组间差异主要集中在术后的第3天和第7天,C、D两组综合评分分别为7.97±0.51、7.21±0.46和5.96±0.36、5.48±0.33,均明显低于同期其他各组（P〈0.05,或P〈0.01）。各组间,第30天时,D组和对照组患者的视力恢复明显好于同期其它各组（P〈0.05）。第90天时,C组、D组和对照组患者的视力恢复明显好于同期的A组和B组（P〈0.05）。术后第90天,A组和B组患者,其黄斑中心凹视网膜厚度分别为（188.92±43.37）μm和（167.23±34.19）μm,明显高于同期其它各组（P〈0.01）。A组和B组的术后黄斑区团块状或血管拱环荧光渗漏病例的发生率分别达18.52%和13.33%,明显高于C组、D组和对照组（P〈0.01）。结论 DM白内障超声乳化手术前后,患者应用氟比洛芬滴眼液能有效预防CME的发生。     

Surgery for idiopathic and secondary epiretinal membranes: functional results and complications

PURPOSE: To evaluate visual outcome after epiretinal membrane surgery. MATERIAL: and method: Retrospective study of 50 consecutive epiretinal membranes (ERM) (23 idiopathic and 27 secondary) with 12 to 42-month follow-up (mean 24 months). Functional evaluations were performed before and after surgery according to the idiopathic or secondary nature of the epiretinal membranes. RESULTS: For idiopathic ERM, vision improved by more than two lines in 43% of the eyes (33% after ERM surgery alone and 55% after ERM followed by cataract surgery) with final visual acuity of 4/10 for 66% of the patients (58% and 82% respectively); there was visual degradation for the two ERM on highly myopic eyes. For the secondary ERM, vision improved by more than 2 lines for 41% of the eyes and final visual acuity of 4/10 for 33% of the patients; visual degradation for almost all ERM secondary to uveitis was associated with preoperative cystoid macular edema. CONCLUSION: After surgery for idiopathic or secondary ERM, visual acuity is good with the exception of the idiopathic ERM on highly myopic eyes and of the uveitic ERM with preoperative cystoid macular edema. Progression of cataract often perturbs visual outcome analysis.     

曲安奈德玻璃体腔内注射治疗白内障术后慢性黄斑囊样水肿

目的观察曲安奈德玻璃体腔内注射治疗白内障术后慢性黄斑囊样水肿的临床疗效。方法对38例38眼白内障术后发生慢性黄斑囊样水肿的患者,行曲安奈德玻璃体腔内注射进行治疗,观察注射后1周、1月、2月、3月患者视力及黄斑中心视网膜厚度的变化及并发症。结果曲安奈德玻璃体腔内注射后,所有患者最佳矫正视力均有不同程度提高,相应的黄斑中心视网膜厚度逐渐变薄,注射后并发症包括球结膜下出血、眼压升高及黄斑囊样水肿复发。结论曲安奈德玻璃体腔内注射对白内障术后慢性黄斑囊样水肿是一种安全、有效的治疗方法,但黄斑囊样水肿复发的原因及再次治疗时机有待进一步观察。     

白内障术后黄斑区光学相干断层扫描动态观察

目的：观察白内障术后黄斑厚度的改变。方法：将126例白内障患者分为两组,分别行常规白内障超声乳化联合人工晶状体植入术64例和小切口非超声乳化联合人工晶状体植入术62例。两组术前、术中无并发症,术前及术后1,3mo黄斑区行OCT检查,观察两组术后黄斑厚度及视力变化。本研究采用SPSS 17.0统计学软件处理,每组术前、后采用配对t检验对数据进行统计学处理; 两组间术前、后分别采用独立样本t检验对数据进行统计学处理,取α=0.05检验水准。结果：两组术后黄斑厚度变化：超声乳化组：术前、术后1,3mo黄斑厚度分别为241.3±10.9, 279.7±16.5,245.6± 12.6μm。术后1mo与术前比较差异有显著差异（P〈0.01）; 术后3mo与术前比较,差异无统计学差异（P〉0.05）; 术后1mo与3mo比较有统计学差异（P〈0.05）。有3例术后1mo出现黄斑囊样水肿,2例术后3mo完全消退。小切口非超声乳化组：术前、术后1,3mo黄斑厚度分别为240.5±11.9,280.9±16.8,246.6±13.2μm。黄斑厚度术后1mo与术前比较有显著统计学差异（P〈0.01）; 术后3mo与术前比较,无统计学差异（P〉0.05）; 术后1mo与3mo比较有统计学差异（P〈0.05）。有2例术后1mo出现黄斑囊样水肿,2例术后3mo完全消退。超声乳化组与小切口非超声乳化组,两组间术前、术后1,3mo分别比较均无统计学差异（P均〉0.05）。结论：无论选择白内障超声乳化还是小切口非超声乳化白内障联合人工晶状体植入,术后1mo黄斑厚度明显增加,证明术后造成黄斑水肿; 术后3mo厚度基本恢复术前。黄斑增厚与术式选择无明显关系。     

The natural history of macular edema after cataract surgery in diabetes

OBJECTIVE: To determine the natural history of macular edema after cataract surgery in diabetes to provide a rational basis for laser therapy. DESIGN: Prospective clinical and angiographic trial. PARTICIPANTS: Thirty-two patients with diabetes undergoing cataract surgery. INTERVENTION: Phacoemulsification surgery with intraoperative fluorescein angiography, and postoperative clinical and angiographic assessment without macular laser therapy for 1 year after surgery. MAIN OUTCOME MEASURES: Clinically significant macular edema, postoperative macular and optic disc hyperfluorescence relative to the intraoperative angiogram, and logarithm of the minimum angle of resolution (LogMAR) visual acuity. RESULTS: In the first postoperative year, macular fluorescence remained at its intraoperative level in 2 (6%) of 32 eyes and increased in 30 (94%) of 32 eyes, returning to its intraoperative level within 1 year of surgery in 13 (43%) of 30 eyes. Optic disc fluorescence remained at its intraoperative level in 2 (6%) of 32 eyes, was not graded in 3 (9%) of 32 eyes, and increased in 27 (84%) of 32 eyes, returning to its intraoperative level within 1 year of surgery in 19 (70%) of 27 eyes. Clinically significant macular edema was identified in the first postoperative year in 18 (56%) of 32 eyes, being present at the time of surgery in 5 eyes and arising de novo within 1 year of surgery in 13 eyes. It resolved spontaneously within 1 year of surgery in 0 of 5 eyes in which it had been present at the time of surgery and in 9 (69%) of 13 eyes in which it arose in the first 6 months after surgery (P = 0.05). Angiographic and clinical resolutions of macular edema were less likely in eyes with more severe retinopathy at the time of surgery (P = 0.03, 0.005). One-year LogMAR acuity of 0.3 or less (> or = 20/40) was achieved in 27 (84%) of 32 eyes. Clinically significant macular edema at the time of surgery was associated with poorer 1-year visual acuity in multivariate analysis (P = 0.005, r2 = 0.5). CONCLUSIONS: Clinically significant macular edema present in diabetic eyes at the time of cataract surgery is unlikely to resolve spontaneously, but clinically significant macular edema arising after surgery commonly resolves, particularly if retinopathy is mild. These findings have implications for the timing of cataract surgery in diabetes and postoperative macular laser therapy. Ophthalmology 1999;106:663-668     

Vitrectomy for chronic pseudophakic cystoid macular edema.

PURPOSE: We report the results of pars plana vitrectomy for chronic pseudophakic cystoid macular edema unresponsive to medical treatment. METHODS: Retrospective analysis of 23 consecutive eyes of 23 patients with chronic pseudophakic cystoid macular edema was performed. Eyes with vitreous incarceration into the cataract wound or vitreous-cornea contact were excluded from the study. Preoperatively, all eyes had cystoid macular edema confirmed on fluorescein angiography and were unresponsive to medical treatment. Pars plana vitrectomy was performed using standard techniques and vitreous adhesions to the iris, intraocular lens, or both were lysed if present. RESULTS: The mean interval between cataract surgery and vitrectomy was 32.3+/-30.9 months (median, 20 months; range, 3 to 110 months). The vitreous was adherent to the iris or intraocular lens in 12 eyes (52.2%) and was present in the anterior chamber with no evidence of adhesions in seven eyes (30.4%). In four eyes (17.4%) the vitreous was posterior to the iris plane with no adhesions to anterior segment structures. The median preoperative best-corrected visual acuity was 20/200, and the median final postoperative best-corrected visual acuity was 20/60 (P<.0001) after a mean follow-up of 30.2+/-31.2 months (median, 14 months; range, 2 to 109 months). Final best-corrected visual acuity improved by a mean of 3.3+/-2.6 Snellen lines, with a median percent change of 70% (mean, 57.3%; range, 0% to 99%). In all 23 eyes the cystoid macular edema resolved postoperatively by biomicroscopic examination in a mean period of 3.3 months (median, 2 months; range, 1 to 12 months). CONCLUSIONS: In pseudophakic eyes with chronic cystoid macular edema unresponsive to medical treatment, vitrectomy resulted in resolution of the cystoid macular edema with improved visual acuity in some cases. Clinical improvement may occur in eyes with no apparent vitreous disturbance.     

Attached posterior hyaloid membrane and the pathogenesis of honeycombed cystoid macular edema in patients with diabetes

PURPOSE: To investigate the pathogenesis of honeycombed cystoid macular edema in patients with diabetes. METHODS: The relationship between the posterior hyaloid membrane and honeycombed cystoid macular edema was examined in 24 eyes of 20 patients with diabetes who underwent vitrectomy for cystoid macular edema. RESULTS: In 19 eyes of 15 patients with diabetes, the posterior hyaloid membrane was attached to the macula, and in five eyes of five patients, the posterior hyaloid membrane was separated from the macula. In 14 (74%) of the 19 eyes with an attached posterior hyaloid membrane, honeycombed cystoid macular edema was detected. Conversely, honeycombed cystoid edema was not detected in any of the five eyes with posterior hyaloid detachment (P = .0059). CONCLUSIONS: These observations demonstrate a strong correlation between an attached posterior hyaloid membrane and the presence of honeycombed cystoid macular edema. We suggest that retinal traction by the posterior hyaloid membrane is involved in the pathogenesis of honeycombed cystoid changes in diabetic patients.