Vitrectomy for clinically non-tractional diabetic macular edema (DME) provides generally good and stable visual outcomes that are maintained for 10 years, according to a study. However, prospective studies are still needed to directly compare its long-term effectiveness with anti-VEGF therapy.
The retrospective study included 332 consecutive patients (496 eyes) who underwent a standard 20-gauge 3-port pars plana vitrectomy performed by a single surgeon between 1990 and 2000. Phakic eyes received combined phacovitrectomy, and the posterior hyaloid was removed in all cases; the internal limiting membrane was peeled in 36.5% of eyes.
Eyes were grouped by follow-up duration, ranging from under 1 year to more than 10 years. Postoperative monitoring spanned 4 to 280 months, with a mean follow-up of 90.9 months. Aside from the smallest cohort (<1 year of follow-up), the groups showed comparable preoperative features and visual trends.
In the group followed for at least 10 years, mean visual acuity improved from a letter score of 51.9 before surgery to 61.7 at 6 months, reaching 63.7 at 1 year and remaining relatively stable through year 10, when the score measured 60.0.
The authors note that additional research will be important to compare vitrectomy with long-term outcomes reported for anti-VEGF therapy and emphasize the need for prospective blinded studies to establish efficacy.
Reference
Kumagai K, Horie E, Fukami M, Furukawa M. Ten-Year Follow-Up of Visual Outcomes After Vitrectomy for Clinically Non-Tractional Diabetic Macular Edema. Cureus. 2025;17(10):e95537. doi: 10.7759/cureus.95537. PMID: 41311758; PMCID: PMC12657103.
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