Surgical removal of choroidal neovascular membranes after laser photocoagulation for diabetic maculopathy.

Purpose: Choroidal neovascularisation (CNV) occurs rarely following laser photocoagulation for macular oedema in diabetic retinopathy, and its management is not well established. We report the clinical course and visual outcomes in a series of patients who underwent surgical extraction of the CNV membrane.

Methods: A retrospective review of 4 cases was carried out.

Results: Two women and 2 men, mean age 59.5 (range 58-62) years, were reviewed. The CNV developed 2-24 (mean 11) months after laser coagulation and resulted in decreased visual acuity to between 6/60 and HM. All underwent pars plana vitrectomy, extraction of the CNV membrane and fluid-air exchange. Follow-up ranged between 9 and 48 months. In 2 patients, the vision improved by 4 and 1 Snellen lines respectively and remained stable, in 1 patient it improved by 1 line initially but then regressed to CF, and in 1 patient it remained unchanged. Recurrence of CNV occurred in only 1 patient. Histological characteristics were those of CNV without evidence of photoreceptors.

Conclusions: This study shows that surgical removal of post-laser CNV is technically feasible despite the previous laser scars and may have beneficial outcome. This surgical approach may provide a therapeutic option in such patients.