ABSTRACT
The role of vitreous traction in producing macular edema has been demonstrated in cystoid macular edema resulting from peripheral uveitis, retinitis pigmentosa, and aphakia. Vitreous traction has also been shown to play a role in diabetic macular edema. This chapter focuses on the surgical management of diabetic macular edema associated with posterior hyaloidal traction. Postoperative complications include vitreous hemorrhage, rhegmatogenous retinal detachment, epiretinal membranes, and cataracts. If epiretinal membranes or cataracts cause significant visual impairment, additional surgery can be considered to improve the visual outcome. The choice of anesthesia for this surgery is based on several factors, including the patient’s renal and cardiac status, their preference, and the anesthesiologist’s skill. The surgical technique begins with a limited, posterior vitrectomy using standard three-port pars plana vitrectomy techniques, including a separate infusion cannula, fiberoptic endoilluminator, and automated vitrectomy probe.
