Purpose: To investigate the efficacy of subthreshold micropulse diode laser photocoagulation (SMDLP) combined with direct photocoagulation.

Methods: Twenty one eyes of 20 patients with diabetic macular edema were treated with SMDLP and direct photocoagulation for microaneurysms within 1 month after SMDLP. The mean visual acuity in logMAR units and central macular thickness (CMT) were evaluated both before and after laser treatment by retrospective chart review and optical coherence tomography (OCT).

Results: The mean visual acuity did not change significantly at 3 and at 6 months. The mean CMT was significantly reduced at 3 and 6 months (3 months: p = 0.018, 6 months: p = 0.004). Visual acuity improved or maintained for 6 months in all of the patients (100%, 20 eyes of 20 patients).

Conclusion: SMDLP combined with direct photocoagulation maintains visual acuity and improves diabetic macular edema for at least 6 months.

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