Stellenwert der Vitrektomie in der Therapie des diabetischen Makulaödems

The pathogenetic of diabetic macula edema is up to now not completley explained. Some factors are known to support the pathogenesis especially the vitreous with its boundary layers. In this retrospective study we investigated in a total of 64 patients (83 eyes) the effects of pars plana vitrectomy on morphology and functionality. Further via the evaluation of the pre- and postoperative characteristics, we searched for positive and negative predictable factors. Similar to earlier studies we found in ours the identical positive effects of vitrectomy in diabetic macula edema. Approximately half of the patients showed positive effects in their sight-improvement. However, ca. 33 % of patients displayed neither positive nor negative effects, 18 % only negative. A decrease in the macula thickness was discovered in 90% of the eyes, that had been operated on using the OCT-measurement method. Although the decrease was significant, it didn't show any correlation with the patients ability to see. The age and their preoperative sight-standard were found to be positive predictive factors. Patients with vitreous bleeding profited less from a vitrectomy and often showed postoperative bleeding, which made the initial re-vitrectomy necessary. In the current therapy of diabetic macular edema, focal laser therapy and intravitreal injection of different active substances are performed. According to the results of this study an earlier decision should be made for a vitrectomy on younger patients with a good ability to see following earlier unsuccessful therapies.