Submacular Injection of Ranibizumab as a New Surgical Treatment for Refractory Diabetic Macular Edema

Purpose. In this study, we describe a new surgical technique for the treatment of refractoryDME. The technique consists of vitrectomywith ILM peeling with a subretinal injection of ranibizumab. Methods. This is a prospective interventional noncomparative study including patients with refractoryDME. Included patients were subjected to the new surgical technique of pars plana vitrectomywith subretinal injection of ranibizumab. Results. The study included 19 eyes with refractory macular edema, in which this novel technique was attempted. There were 10 males and 9 females. The age of the patients ranged from 17 to 67 years with a mean of 55.58 ± 13.242 years. The duration of diabetes before enrollment in the study ranged from 7 to 25 years with a mean of 16.3 years. Preoperatively, the mean CMT of the eyes ranged from 352 to 883 micronswith mean ± SD of 498.58 ± 152.16 microns. Postoperatively, this improved significantly to 373.5 ± 100.3, 355.9 ± 89.8, and 365.74 ± 120.12 micronsat 1, 3, and 6 months, respectively ( for all). Conclusion. This novel surgical procedure of vitrectomywith ILM peeling with a subretinal injection of ranibizumabis effective in cases of refractoryDME. The study has been registered in Contact ClinicalTrials.gov PRS Identifier: NCT03975088.