Pre and Postoperative OCT Findings Following Management of Diabetic Vitreoretinal Traction Maculopathy Using 23 Gauge Vitrectomy

Abstract

Background: Pars Plana Vitrectomy (PPV) is an essential surgery for advanced diabetic retinopathy, particularly in cases had vitreous hemorrhage or traction. The 23-gauge system improves safety and precision in such procedures.

Aim: To assess central macular thickness utilizing Optical Coherence Tomography (OCT) before and after 23-gauge vitrectomy in cases had diabetic vitreoretinal traction maculopathy.

Patients and methods: This retrospective research included 48 eyes had vitreomacular traction and diabetic macular edema (DME). Visual acuity ranged from 0.5 to 1.3 LogMAR, and central macular thickness measured by OCT was greater than 300 microns. Follow-up visits were conducted every 2-months, with the 6-month visit serving as the study endpoint. The investigation has been performed at the Research Institute of Ophthalmology (RIO).

Results: The study included 48 eyes with a mean age of 65.6 years. Preoperative mean Central Macular Thickness (CMT) was 475 µm and BCVA was 1.03 LogMAR. At 2 months postoperatively, 70% showed >50 µm CMT reduction; at 6 months, 66% maintained this reduction. BCVA improved in 22% at 2 months and 25% at 6 months, with 52–58% showing no change. Postoperative complications occurred in 33% of eyes, and lens changes developed in 78% of phakic eyes. Poor final BCVA (≥1.3 LogMAR) was significantly associated with baseline BCVA <1.3 and ischemic macula (P<0.001).

Conclusion: Vitrectomy is beneficial for chronic VMT, particularly in younger patients with good vision and non-ischemic macula, and can still yield positive outcomes after 6 months.