Planned foveal detachment technique for the resolution of diffuse diabetic macular edema

Yuki Morizane, Shuhei Kimura, Mio Hosokawa, Yusuke Shiode, Masayuki Hirano, Shinichiro Doi, Mika Hosogi, Atsushi Fujiwara, Yasushi Inoue, Fumio Shiraga

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)279-287
Number of pages9
JournalJapanese Journal of Ophthalmology
Volume59
Issue number5
DOIs
Publication statusPublished - Sep 14 2015

Keywords

  • Diffuse diabetic macular edema
  • Foveal detachment
  • Vitrectomy

ASJC Scopus subject areas

  • Ophthalmology

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