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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 10553
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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Good day i was diagnosed last june with diabetic retinopathy

Customer Question

Good day

i was diagnosed last june with diabetic retinopathy , and macular edema . the doctor treated me anti VEGF , for the both eyes. 1 week apart . and laser session. after couple of months the macular edema did not response well in the first treatment , so the doctor considered early vitrectomy,, but i resisted hoping another shot of the anti VEGF will work out well.. so it did... the edema subside the vessels start to shrink... but now it feel the edema is coming back. my vision starts to distort again ... my question is another anti VEGF or Early Vitrectomy .. what is the disadvantage and advantage , and i wonder what is my vision after vitrectomy is it blurry, hazy or something.. so many questions running through my mind .. bit confused ...

thanks you
Morris john john uy
30 years old
type1 diabetic
Submitted: 6 years ago.
Category: Eye
Expert:  Dr. Rick replied 6 years ago.

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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Customer: replied 6 years ago.
thank you docotr for the advice. ill consider the vitrectomy. thank you . .

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