The approach to managing diabetic macular edema (DME) in eyes with prior vitrectomy is based on limited evidence. Therefore, an exploratory post-hoc assessment of 3-year data from eyes with and without vitrectomy prior to randomization in a DRCR.net trial that evaluated ranibizumab+prompt or deferred laser for DME is presented.
Visual acuity (VA) and ocular coherence tomography (OCT) outcomes were compared between eyes with and without prior vitrectomy.
At baseline eyes with prior vitrectomy (n = 25) had longer duration of diabetes, worse VA, less thickened central subfield measurements on OCT, and were more apt to have worse diabetic retinopathy severity level or prior treatment for macular edema or cataract surgery than eyes without a history of vitrectomy (n = 335). Analyses adjusted for these baseline imbalances did not identify substantial differences between eyes with and without prior vitrectomy at each annual visit through 3 years for the favorable VA, OCT central subfield thickness or volume outcomes, although OCT improvement appeared slower in vitrectomy eyes during the first year.