Hi. I'll be happy to help you with your question.
It sounds like you are suffering from diabetic macular edema. You probably have some degree of diabetic retinopathy also. Prior to the advent of the excellent anti VEGF injections we now have the major treatment available for your condition was laser and vitrectomy.
As you already know the intraocular injections are not without risk, nor is vitrectomy surgery. It is great that you had good results with the injections and laser but the fact that your symptoms have returned tells me that the source of your problem still exists. The Avastin or Leucentis injections only treat the VEGF that is present in your eye, they -- unlike the laser therapy -- do nothing to stop new VEGF from forming.
I agree with your surgeon that vitrectomy may help more then continued injections and laser. During vitrectomy the jelly in the back of your eye is removed (thus removing the VEGF that is present) and, if indicated, endolaser is applied directly to the most affected areas of your retina. At the end of the surgery your eye may be refilled with fluid or, depending on the condition of your retina, a gas. The gas is resorbed over time and replaced with natural fluids. After vitrectomy surgery your vision will be blurry. How long will it be blurry? That varies with the exact surgery performed, if you have gas left in your eye, the health of your macula etc.
What is the take home message here? That there is no wrong or right answer, only choices. I get the feeling from your statement that you are in excellent hands with the ophthalmologist who is currently treating you.
Without doing a complete examination of your eye I really can't tell you what to do....but, of course, you understand this. I can, however, tell you that my feeling is that, if you have persistent diabetic macular edema after 2 anti-VEGF injections and focal/grid laser treatment vitrectomy surgery is a good alternative to continued injections.
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