Pars plana vitrectomy for refractory diabetic macular edema

Objective. The aim of this study is to describe the results of pars plana vitrectomy (PPV) for refractory diabetic macular edema (DME). Methods. Review of the relevant peer-reviewed scientific literature identified using Medline. Main Outcome Measures. The anatomical and functional outcome of surgery. Results. Vitrectomy with or without internal limiting membrane (ILM) peeling can be beneficial for the treatment of DME that is resistant to laser photocoagulation or sub-Tenon's steroid injection. Visual improvement has been reported in ∼40-90% of patients, with ∼85-100% experiencing either improvement or stabilization of vision. Retinal edema decreases or resolves in ∼70-100% of patients. Complications range in severity with ∼5-20% of patients developing peripheral retinal breaks, ∼1-2% developing retinal detachment, ∼2% developing macular hole, and ∼10-60% developing cataract. Severe complications such as rubeosis iridis and the fibrinoid syndrome have also been reported. Conclusion. Pars plana vitrectomy can be an effective treatment for diabetic macular edema refractory to laser therapy and/or sub-Tenon's capsule steroid injection.