Surgical treatment outcomes of resistant diabetic macular edema

Objective: to analyze the impact of surgical intervention in resistant diabetic macular edema (DME) on the morphological and functional parameters of the retina according to OCT and microperimetry data. Material and methods. 75 patients diagnosed with resistant DME: group 1 (25 patients, 25 eyes) underwent intravitreal administration of anti-VEGF drugs; group 2 (26 patients, 26 eyes) underwent vitrectomy with membrane peeling; group 3 (24 patients, 24 eyes) underwent vitrectomy with membrane peeling and subretinal administration of balanced salt solution (BSS). Results. After 1 week, the thickness of the fovea in the group 3 decreased by 1.3 times (p=0.043 compared to the 1st group), by 1.2 times (p=0.044, compared to the group 2), after 1 month by 1.5 times (p=0.041) and by 1.2 times (p=0.044). After 6 months by 1.2 times (p=0.042) in the group 2 and by 1.4 times (p=0.042) in the group 3, compared to the group 1. After 12 months by 1.3 times less in the group 3 (p=0.043 compared to the 1st group). When analyzing the best-corrected visual acuity after 6 months, the functional results of patients in groups 2 and 3 improved by 1.8 times (p=0.038) and 1.9 times (p=0.039) compared to those in group 1. Light sensitivity 1 week after surgery in groups 2 was 1.4 times (p=0.042) and in groups 3 was 1.5 times (p=0.041) higher than those in group 1. Conclusion. In the treatment of DME, vitreoretinal surgery plays an important role in changing retinal parameters, contributing to a decrease in thickness in the early stages, an increase in light sensitivity and an increase in best-corrected visual acuity.