Asahina Yuichi, Tachi Naoko, Asahina Yumi, Yoshimura Kayoko, Ueta Yoshiki, Hashimoto Yoshihiro
Eye Center, Shinseikai Toyama Hospital, Imizu, Toyama, Japan.
Clin Ophthalmol. 2017 Nov 23;11:2099-2105. doi: 10.2147/OPTH.S150385. eCollection 2017.
This study evaluated the outcomes of surgical cystotomy for recurrent diabetic cystoid macular edema (CME).
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.
CRT, CMMT and MV significantly improved 1 and 6 months post surgery in each group (<0.01). Significant improvements in BCVA were only observed 6 months post surgery (<0.01). No intra- or postoperative complications were observed in all patients.
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.
本研究评估了手术性膀胱切开术治疗复发性糖尿病性黄斑囊样水肿（CME）的效果。
我们分析了20例临床诊断为糖尿病性视网膜病变和难治性CME的患眼。每位患者均进行了玻璃体视网膜粘连松解、视网膜前膜（ERM）和内界膜（ILM）剥除以及术中光学相干断层扫描（iOCT）引导下的膀胱切开术。17例患者还进行了玻璃体切除术，其中11例还接受了晶状体切除术和人工晶状体植入术。比较术前以及术后1个月和6个月时的中心视网膜厚度（CRT）、中心黄斑最小厚度（CMMT）、黄斑体积（MV）和最佳矫正视力（BCVA）。
每组患者术后1个月和6个月时CRT、CMMT和MV均显著改善（<0.01）。仅在术后6个月时观察到BCVA有显著改善（<0.01）。所有患者均未观察到术中或术后并发症。
手术性膀胱切除术6个月后CRT、CMMT、MV和BCVA均显著改善。这意味着iOCT引导下的膀胱切开术可能是糖尿病性眼难治性CME的另一种治疗选择。
