VITRECTOMY FOR DIABETIC MACULAR EDEMA ASSOCIATED WITH A THICKENED ANDTAUT POSTERIOR HYALOID MEMBRANE

PURPOSE: To evaluate the surgical results in a series of patients with diabetic macular edema associated with traction from a thickened and taut posterior hyaloid membrane and to identify features associated wi th better visual outcome. METHODS: We reviewed the clinical records of ten consecutive patients who underwent pars plana vitrectomy in one e ye for diabetic macular edema that was preoperatively attributed to th ickening and traction of the posterior hyaloid membrane. RESULTS: Best corrected, preoperative visual acuity was 20/200 in seven eyes, 20/30 0 in one eye, and 20/400 in two eyes. Intraoperatively, seven patients were found to have an attached posterior hyaloid membrane which was t hickened and taut, Among these seven patients, postoperative best-corr ected visual acuity improved by six lines in two eyes, by five lines i n one eye, by two lines in one eye, and remained within one line of pr eoperative visual acuity in three eyes, The other three patients had a n epiretinal membrane simulating an attached and thickened posterior h yaloid membrane. CONCLUSIONS: Vitrectomy effectively improved visual a cuity in some eyes with diabetic macular edema associated with tractio n from a thickened and taut posterior hyaloid membrane. Despite carefu l preoperative examination with a fundus contact lens, however, in som e patients it may be difficult to assess how the posterior hyaloid mem brane contributes to the macular edema. In selected patients, early su rgical intervention may be associated with better visual outcome.