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Six-month postoperative outcomes of intraoperative OCT-guided surgical cystotomy for refractory cystoid macular edema in diabetic eyes

Authors Asahina Y, Tachi N, Asahina Y, Yoshimura K, Ueta Y, Hashimoto Y

Received 30 August 2017

Accepted for publication 25 October 2017

Published 23 November 2017 Volume 2017:11 Pages 2099—2105


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Scott Fraser

Supplementary video showing surgical procedure of cystotomy. Notes: The temporal margin of the cystoid space was vertically incised using a 27-gage needle, followed by an additional horizontal incision and flushing the cystoid space with 50–100 μL ba

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Yuichi Asahina, Naoko Tachi, Yumi Asahina, Kayoko Yoshimura, Yoshiki Ueta, Yoshihiro Hashimoto

Eye Center, Shinseikai Toyama Hospital, Imizu, Toyama, Japan

Purpose: This study evaluated the outcomes of surgical cystotomy for recurrent diabetic cystoid macular edema (CME).
Patients and methods: We analyzed 20 eyes with a clinical diagnosis of diabetic retinopathy and refractory CME. Release of vitreoretinal adhesion, epiretinal membrane (ERM) and internal limiting membrane (ILM) peeling and cystotomy guided by intraoperative optical coherence tomography (iOCT) were performed in every patient. Pars plana vitrectomy was also performed in 17 patients, 11 of whom also underwent lensectomy and intraocular lens implantation. Central retinal thickness (CRT), central minimum macular thickness (CMMT), macular volume (MV) and best-corrected visual acuity (BCVA) were compared preoperatively and 1 and 6 months post surgery.
Results: CRT, CMMT and MV significantly improved 1 and 6 months post surgery in each group (P<0.01). Significant improvements in BCVA were only observed 6 months post surgery (P<0.01). No intra- or postoperative complications were observed in all patients.
Conclusion: CRT, CMMT, MV and BCVA significantly improved 6 months following surgical cystectomy. This implies that iOCT-guided cystotomy could be another treatment option for refractory CME in diabetic eyes.

Keywords: diabetic retinopathy, cystoid macular edema, intraoperative OCT, cystotomy

A Letter to the Editor has been received and published for this article.


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