A 65-year-old man presented with a 21-year history of reasonably well-controlled diabetes. He had medical history diabetic retinopathy, pseudophakic, and recalcitrant diabetic macular edema. The patient had been treated with everything from focal laser, to anti-vascular endothelial growth factor therapy with Ranibizumab, Bevacizumab, and Triamcinolone, yet he remained recalcitrant.
His visual acuity was 20/50, and he had received 7 Ranibizumab injections, 5 Bevacizumab injections, and treatment with 2 focal laser treatments, and still could not get the cysts to resolve. What is your alternate management step?
