TY - JOUR
T1 - Planned foveal detachment technique for the resolution of diffuse diabetic macular edema
AU - Morizane, Yuki
AU - Kimura, Shuhei
AU - Hosokawa, Mio
AU - Shiode, Yusuke
AU - Hirano, Masayuki
AU - Doi, Shinichiro
AU - Hosogi, Mika
AU - Fujiwara, Atsushi
AU - Inoue, Yasushi
AU - Shiraga, Fumio
N1 - Publisher Copyright:
© 2015, Japanese Ophthalmological Society.
PY - 2015/9/14
Y1 - 2015/9/14
N2 - Purpose: To evaluate the therapeutic efficacy of a novel surgical procedure for diffuse diabetic macular edema (DME), performed in conjunction with conventional vitrectomy. Methods: This prospective, interventional case series involved 20 eyes of 18 consecutive DME patients with best-corrected visual acuities (BCVAs) between 0.301 and 1.221 logarithm of the minimal angle of resolution (logMAR) units and central retinal thicknesses (CRTs) greater than 275 μm. After vitrectomy, a small retinal detachment was made in the macula by injecting 50–100 μl balanced salt solution into the subretinal space using a 38-gauge needle. Before finishing the surgery, fluid-air exchange was performed. Patients were asked to remain in prone position for 1 day postoperatively. The main outcome measures were CRT and BCVA. Results: The mean CRT of 554.6 ± 152.7 μm before surgery significantly decreased to 295.6 ± 92.5 μm (p < 0.0001) 1 week after surgery and to 185.8 ± 67.4 μm (p < 0.0001) at 6 months after surgery. The CRT was less than 250 μm in 18 eyes (90 %) at 6 months after surgery. The mean BCVA before surgery (0.706 ± 0.348) significantly improved at 6 months after surgery (0.431 ± 0.392, p < 0.0001). Postoperative BCVAs improved by more than 0.3 logMAR units in 13 eyes (65 %), remained unchanged in six eyes (30 %) and worsened in one eye (5 %). Macular edema recurred in three eyes (15 %) 2 months after surgery. Conclusions: This novel planned foveal detachment technique facilitated a rapid resolution of DME and contributed to improved visual acuity.
AB - Purpose: To evaluate the therapeutic efficacy of a novel surgical procedure for diffuse diabetic macular edema (DME), performed in conjunction with conventional vitrectomy. Methods: This prospective, interventional case series involved 20 eyes of 18 consecutive DME patients with best-corrected visual acuities (BCVAs) between 0.301 and 1.221 logarithm of the minimal angle of resolution (logMAR) units and central retinal thicknesses (CRTs) greater than 275 μm. After vitrectomy, a small retinal detachment was made in the macula by injecting 50–100 μl balanced salt solution into the subretinal space using a 38-gauge needle. Before finishing the surgery, fluid-air exchange was performed. Patients were asked to remain in prone position for 1 day postoperatively. The main outcome measures were CRT and BCVA. Results: The mean CRT of 554.6 ± 152.7 μm before surgery significantly decreased to 295.6 ± 92.5 μm (p < 0.0001) 1 week after surgery and to 185.8 ± 67.4 μm (p < 0.0001) at 6 months after surgery. The CRT was less than 250 μm in 18 eyes (90 %) at 6 months after surgery. The mean BCVA before surgery (0.706 ± 0.348) significantly improved at 6 months after surgery (0.431 ± 0.392, p < 0.0001). Postoperative BCVAs improved by more than 0.3 logMAR units in 13 eyes (65 %), remained unchanged in six eyes (30 %) and worsened in one eye (5 %). Macular edema recurred in three eyes (15 %) 2 months after surgery. Conclusions: This novel planned foveal detachment technique facilitated a rapid resolution of DME and contributed to improved visual acuity.
KW - Diffuse diabetic macular edema
KW - Foveal detachment
KW - Vitrectomy
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U2 - 10.1007/s10384-015-0390-4
DO - 10.1007/s10384-015-0390-4
M3 - Article
C2 - 26220819
AN - SCOPUS:84941413472
VL - 59
SP - 279
EP - 287
JO - Japanese Journal of Ophthalmology
JF - Japanese Journal of Ophthalmology
SN - 0021-5155
IS - 5
ER -