Macular grid photocoagulation after intravitreal triamcinolone acetonide for diffuse diabetic macular edema

Objective: To evaluate the clinical outcomes of macular laser photocoagulation after the intravitreal injection of 4 mg of triamcinolone acetonide (IVTA) for diffuse diabetic macular edema (DME). Methods: Eighty-six eyes of 74 patients with diffuse DME were randomized into 2 groups. The laser group eyes (n = 48) were subjected to a macular grid laser photocoagulation 3 weeks after IVTA. The control group eyes (n = 38) underwent only IVTA. Both groups were compared with regard to the changes in visual acuity and central macular thickness at 3 weeks, 3 months, and 6 months after IVTA. Results: The mean central macular thickness before, 3 weeks after, and 3 and 6 months after IVTA were 538, 250, 295, and 301 mu m in the laser group vs 510, 227, 302, and 437 mu m in the control group, respectively. The logMAR visual acuities were not significantly different between the 2 groups at baseline and at 3 weeks after IVTA but were significantly better in the laser group at 3 (P=.02) and 6 months( P <.001) after IVTA. Conclusions: Macular laser coagulation effectively maintains improved visual acuity after IVTA for diffuse DME and is believed to reduce recurrent DME after IVTA.