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Purpose <p>To determine whether adding pars plana vitrectomy (PPV) to phacoemulsification and intraocular lens implantation (PEI) promotes long-term macular stability in eyes with subclinical diabetic macular edema (DME), defined as fluorescein angiography–positive macular leakage without optical coherence tomography (OCT)–evident center-involving macular edema (CI-ME).</p> Methods <p>We conducted a retrospective study including 79 eyes with subclinical DME; 35 eyes underwent PPV with PEI (PPV-PEI), and 44 eyes underwent PEI alone. Outcomes were assessed at baseline, 1 year, and the final follow-up visit (mean follow-up &gt; 6 years), including best-corrected visual acuity (BCVA), central macular thickness (CMT), CI-ME, and epiretinal membrane (ERM) formation.</p> Results <p>Baseline CMT was higher in PPV-PEI than in PEI (<i>p</i> = 0.028), whereas baseline BCVA was comparable. BCVA improved at 1 year in both treatments (both <i>p</i> &lt; 0.001) and remained similar at the final visit. In PPV-PEI, CMT increased transiently at 1 year (<i>p</i> &lt; 0.001 vs. baseline) and then decreased toward baseline by the final visit (<i>p</i> = 0.005 vs. 1 year), whereas PEI showed persistently elevated CMT (<i>p</i> &lt; 0.001 at 1 year; <i>p</i> = 0.017 at final). Final OCT-evident CI-ME tended to be less frequent in PPV-PEI (11.4%) than in PEI (29.5%). Within PPV-PEI, internal limiting membrane peeling was associated with fewer ERMs (<i>p</i> = 0.012) and independently associated with lower final CMT (<i>p</i> = 0.039).</p> Conclusion <p>Adding PPV to PEI was associated with preserved BCVA and improved long-term macular stability in eyes with subclinical DME.</p>

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Concurrent vitrectomy with phacoemulsification for subclinical diabetic macular edema: a long-term comparative study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月17日

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  • Takafumi Suzuki,
  • Naoko Tachi,
  • Hideo Tate,
  • Yasuhiro Okamoto,
  • Nobuya Tanaka,
  • Anzu Masuko,
  • Masako Nagahara,
  • Kentaro Hayashi,
  • Ryo Terao,
  • Takashi Ueta,
  • Megumi Honjo,
  • Yoshiki Ueta

摘要

Purpose

To determine whether adding pars plana vitrectomy (PPV) to phacoemulsification and intraocular lens implantation (PEI) promotes long-term macular stability in eyes with subclinical diabetic macular edema (DME), defined as fluorescein angiography–positive macular leakage without optical coherence tomography (OCT)–evident center-involving macular edema (CI-ME).

Methods

We conducted a retrospective study including 79 eyes with subclinical DME; 35 eyes underwent PPV with PEI (PPV-PEI), and 44 eyes underwent PEI alone. Outcomes were assessed at baseline, 1 year, and the final follow-up visit (mean follow-up > 6 years), including best-corrected visual acuity (BCVA), central macular thickness (CMT), CI-ME, and epiretinal membrane (ERM) formation.

Results

Baseline CMT was higher in PPV-PEI than in PEI (p = 0.028), whereas baseline BCVA was comparable. BCVA improved at 1 year in both treatments (both p < 0.001) and remained similar at the final visit. In PPV-PEI, CMT increased transiently at 1 year (p < 0.001 vs. baseline) and then decreased toward baseline by the final visit (p = 0.005 vs. 1 year), whereas PEI showed persistently elevated CMT (p < 0.001 at 1 year; p = 0.017 at final). Final OCT-evident CI-ME tended to be less frequent in PPV-PEI (11.4%) than in PEI (29.5%). Within PPV-PEI, internal limiting membrane peeling was associated with fewer ERMs (p = 0.012) and independently associated with lower final CMT (p = 0.039).

Conclusion

Adding PPV to PEI was associated with preserved BCVA and improved long-term macular stability in eyes with subclinical DME.