Six-month postoperative outcomes of intraoperative OCT-guided surgical cystotomy for refractory cystoid macular edema in diabetic eyes

Abstract

Purpose

This study evaluated the outcomes of surgical cystotomy for recurrent diabetic cystoid macular edema (CME).

Patients and methods

We analyzed 20 eyes with a clinical diagnosis of diabetic retinopathy and refractory CME. Release of vitreoretinal adhesion, epiretinal membrane (ERM) and internal limiting membrane (ILM) peeling and cystotomy guided by intraoperative optical coherence tomography (iOCT) were performed in every patient. Pars plana vitrectomy was also performed in 17 patients, 11 of whom also underwent lensectomy and intraocular lens implantation. Central retinal thickness (CRT), central minimum macular thickness (CMMT), macular volume (MV) and best-corrected visual acuity (BCVA) were compared preoperatively and 1 and 6 months post surgery.

Results

CRT, CMMT and MV significantly improved 1 and 6 months post surgery in each group (P<0.01). Significant improvements in BCVA were only observed 6 months post surgery (P<0.01). No intra- or postoperative complications were observed in all patients.

Conclusion

CRT, CMMT, MV and BCVA significantly improved 6 months following surgical cystectomy. This implies that iOCT-guided cystotomy could be another treatment option for refractory CME in diabetic eyes.

Keywords:

• diabetic retinopathy
• cystoid macular edema
• intraoperative OCT
• cystotomy

Author contributions

Yuichi Asahina, NT, Yumi Asahina, KY, YU, YH prepared the material. Yuichi Asahina and NT wrote the main manuscript text and prepared figures. Yuichi Asahina, NT, Yumi Asahina, KY, YU and YH reviewed the manuscript. All authors contributed toward data analysis, drafting and critically revising the paper and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.