F. Becquet, J.F. Le Rouic, D. Ducournau, Department of vitreo-retinal surgery, Clinique Sourdille, Nantes, France


To investigate visual acuity and optical coherence tomographic (OCT) outcomes, and adverse events, associated with intravitreal triamcinolone acetonide (TA) injection and pars plana vitrectomy for diabetic macular edema (DME).


Retrospective, non-comparative, interventional, consecutive case series. Records were reviewed of twenty eight eyes of twenty four patients treated for DME. The eyes were classified according the surgical procedure into two groups: 8 eyes (group I) treated by a vitrectomy with internal limiting membrane (ILM) removal without TA injection; 20 eyes (group II)   treated by vitrectomie with ILM peeling and TA injection. We report six month follow-up visual acuity as well as OCT measurements.


The mean preoperative visual acuity was 20/160 (ETDRS=38). The mean postoperative visual acuity after 6 months was 20/100 (ETDRS=50). The postoperative visual acuity after 6 months resulted in improvement, invariability and deterioration levels of 75%, 18% and 7%, respectively. The percentage of postoperative visual improvement, invariability and deterioration levels of group it was 37.5%, 50% and 12.5%, respectively. For group II, it was 80%, 15% and 5%, respectively. We found a significant statistical difference in the improvement levels of the two groups (p≤0.05). Mean foveal thickness was 471 mm at baseline, compared to 285 mm at 6 months (p≤0.05). Intraocular pressure elevation >10mmHg compared to pre-injection occurred in 3/28 eyes at 1 month, and 0/28 eyes at 6 months. No cases of sterile or infectious endophthalmitis occurred and no steroid-induced glaucoma developed.


The present study suggests that it’s better to perform vitrectomy with ILM peeling and TA injection than vitrectomy with ILM peeling alone in DME. Case-controlled studies are necessary to assess the benefit of this combined therapy.