Bonnin Sophie, Sandali Otman, Bonnel Sébastien, Monin Claire, El Sanharawi Mohamed
*Department of Ophthalmology, Quinze-Vingts National Ophthalmology Hospital, Paris, France; and †National Institute of Health and Medical Research, Cordeliers Research Center, Physiopathology of Ocular Diseases: Therapeutic Innovations, Pierre and Marie Curie University, Paris, France.
Retina. 2015 May;35(5):921-8. doi: 10.1097/IAE.0000000000000433.
To compare the long-term outcomes of vitreomacular surgery in eyes with nontractional diabetic macular edema (DME) with those from eyes with tractional DME.
Retrospective comparative study from 55 consecutive patients (73 eyes). Twenty eyes were operated on for tractional DME and 53 eyes for nontractional DME unresponsive to laser photocoagulation or triamcinolone intravitreal injections. The best-corrected visual acuity, the central macular thickness, and the surgical complications were analyzed.
The mean follow-up duration was 5.3 ± 2.4 years for the group with traction and 4.4 ± 1.7 years for the group without traction (P = 0.13). At 3 years, the mean logarithm of the minimum angle of resolution best-corrected visual acuity had improved significantly from 0.78 to 0.58 for the group without traction and from 0.75 to 0.45 for the group with traction (P < 0.001). At the final visit, there was no significant difference between the 2 groups in regard to visual or central macular thickness improvement (P = 0.447 and P = 0.742, respectively). The incidence of surgical complications was not significant between the two groups. The preoperative best-corrected visual acuity was the only predictive factor for the final best-corrected visual acuity.
The results of vitrectomy were not different in terms of anatomical and visual outcomes and surgical complications between eyes without tractional DME and eyes with tractional DME.
比较非牵引性糖尿病性黄斑水肿（DME）眼与牵引性DME眼玻璃体黄斑手术的长期效果。
对55例连续患者（73只眼）进行回顾性比较研究。20只眼因牵引性DME接受手术，53只眼因对激光光凝或曲安奈德玻璃体腔内注射无反应的非牵引性DME接受手术。分析最佳矫正视力、黄斑中心厚度和手术并发症。
牵引组的平均随访时间为5.3±2.4年，非牵引组为4.4±1.7年（P = 0.13）。3年时，非牵引组的最小分辨角对数最佳矫正视力从0.78显著提高到0.58，牵引组从0.75提高到0.45（P < 0.001）。在最后一次随访时，两组在视力或黄斑中心厚度改善方面无显著差异（分别为P = 0.447和P = 0.742）。两组手术并发症的发生率无显著差异。术前最佳矫正视力是最终最佳矫正视力的唯一预测因素。
非牵引性DME眼和牵引性DME眼在玻璃体切除手术的解剖和视觉效果以及手术并发症方面结果无差异。
