Surgical treatment outcomes of resistant diabetic macular edema

Objective: to analyze the effect of surgical intervention in resistant diabetic macular edema (DME) on morphological and functional parameters of the retina according to optical coherence tomography (OCT) and microperimetry data. Materials and methods. Our study included 75 patients diagnosed with resistant DME: Group 1 (25 patients, 25 eyes) treated with intravitreal injection of anti-VEGF drugs; Group 2 (26 patients, 26 eyes) undergoing vitrectomy (VE) with internal limiting membrane peeling; Group 3 (24 patients, 24 eyes) undergoing VE with internal limiting membrane peeling and submacular injection of balanced salt solution (BSS). Results. After 1 wk., the foveal thickness in Group 3 decreased by 1.3 times (p=0.043) compared with Group 1 and 1.2-fold (p=0.044) compared with Group 2; after 1 mo.: by 1.5 times (p=0.041) and 1.2-fold (p=0.044); after 6 mos.: by 1.2 times (p=0.042) in Group 2 and 1.4-fold (p=0.042) in Group 3 against Group 1; after 12 mos.: by 1.3 times in Group 3 (p=0.043) against Group 1. When analyzing the best corrected visual acuity (BCVA) after 6 mos., the functional results in patients of Groups 2 and 3 improved by 1.8 times (p=0.038) and 1.9 times (p=0.039), respectively against Group 1. Light sensitivity 1 wk. after surgery was 1.4 times higher in Group 2 (p=0.042) and 1.5 times higher in Group 3 (p=0.041) than 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 BCVA.