Surgical removal of choroidal neovascular membranes after laser photocoagulation for diabetic maculopathy

Purpose Choroidal neovascularisation (CNV) occurs rarely following laser ph otocoagulation for macular oedema in diabetic retinopathy, and its manageme nt is not well established. We report the clinical course and visual outcom es in a series of patients who underwent surgical extraction of the CNV mem brane. Methods A retrospective review of 4 cases was carried out. Results Two women and 2 men, mean age 59.5 (range 58-62) years, were review ed. The CNV developed 2-24 (mean 11) months after laser coagulation and res ulted in decreased visual acuity to between 6/60 and HM. All underwent pars plana vitrectomy, extraction of the CNV membrane and fluid-air exchange. F ollow-up ranged between 9 and 48 months. In 2 patients, the vision improved by 4 and 1 Snellen lines respectively and remained stable, in 1 patient it improved by 1 line initially but then regressed to CF, and in 1 patient it remained unchanged. Recurrence of CNV occurred in only 1 patient. Histolog ical characteristics were those of CNV without evidence of photoreceptors. Conclusions This study shows that surgical removal of post-laser CNV is tec hnically feasible despite the previous laser scars and may have beneficial outcome. This surgical approach may provide a therapeutic option in such pa tients.