Evaluation of planned foveal detachment technique for rapid resolution of resistant diabetic macular oedema

Purpose: Diabetic macular edema (DME) is the main cause of the diminution of vision in diabetic patients. There are many pharmacological and surgical modalities used for the treatment of DME, however, the refractory DME still represents a challenge, because of the associated lower success rates. Aim of the work: The evaluation of effectiveness and safety of planned foveal detachment technique in rapid resolution of DME in cases resistant to anti Vascular Endothelial Growth Factor (Anti VEGF) therapy as regards macular anatomy and function. Patients and methods: This study included 36 patients with diffuse or cystoid DME despite undergoing anti-VEGF therapy at least 6 times and recruited from Mansoura ophthalmic center. All cases were subjected to taking full history and full ophthalmological examination including assessment by spectral- domain OCT. All the included cases underwent planned foveal detachment technique, and follow up was done at one-week, one month, 3 months, and 6 months post- operative. Results : There was a statistically significant post-operative improvement in the best-corrected visual acuity (BCVA) at 1 week, 1 month, and 3 months, as compared with the preoperative values. There was a statistically significant post-operative reduction in the central foveal thickness (CFT) at 1 week, 1 month, 3 months, and 6 months compared to preoperative values. Conclusion : Planned foveal detachment technique was an effective technique that is associated with relatively rapid improvement of BCVA and CFT among cases with DME who were resistant to treatment by Anti VEGF.