How JustAnswer Works:
  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site. Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.
Ask Dr. Rick Your Own Question
Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 11417
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
Type Your Eye Question Here...
Dr. Rick is online now
A new question is answered every 9 seconds

I was diagnosed last june with diabetic retinopathy, and

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: 7 years ago.
Category: Eye
Expert:  Dr. Rick replied 7 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.

It was a pleasure to assist you. Please, allow me get credit for my time and effort in assisting you and press the ACCEPT button for this assist. I will be glad to answer additional questions until you are satisfied. Thank you so much.

A Positive Feedback and/or Bonus is welcomed and appreciated.

Dr. Rick and other Eye Specialists are ready to help you
Customer: replied 7 years ago.
thank you docotr for the advice. ill consider the vitrectomy. thank you . .