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Thi Ha Chau Tran,1 Ali Erginay,2 Stephane Verdun,3 Eric Fourmaux,4 Jean-François Le Rouic,5 Joel Uzzan,6 Solange Milazzo7 ,† Stephanie Baillif,8 Laurent Kodjikian9 1Service d’Ophtalmologie, Université Catholique de Lille, Faculté de Médecine et Maieutique, INSERM U1171, Lille, France; 2Service d’Ophtalmologie, Hôpital Lariboisière APHP, Universite de Paris, Paris, France; 3Département de Recherche Médicale, Groupement des Hôpitaux Catholiques de Lille, Lille, France; 4Centre Rétine Gallien, Bordeaux, France; 5Institut Ophtalmologique de l’Ouest Jules Verne, Ophtalliance, Nantes, France; 6Clinique Mathilde, Rouen, France; 7Service d’Ophtalmologie, Centre Hospitalier Universitaire d’Amiens Picardie, Université de Picardie Jules Verne, Amiens, France; 8Service d’Ophtalmologie, Centre Hospitalier Université Côte d’Azur, Université Côte d’Azur, Nice, France; 9Service d’Ophtalmologie, Croix Rousse Hospital, Hospice Cilvils de Lyon 1, Université de Lyon 1, Lyon, France†Solange Milazzo passed away on March 23, 2019Correspondence: Thi Ha Chau TranService d’Ophtalmologie, Université Catholique de Lille, Faculté de Médecine et Maieutique, INSERM U1171, Boulevard de Belfort, BP387, Lille, Cedex, 59021, FranceTel +33 3 20 87 74 42Fax + 33 20 87 75 58Email tran.hachau@ghicl.netAim: To evaluate the efficacy of intravitreal Aflibercept injection (IAI) for vitrectomized eyes with diabetic macular edema (DME) at one year.Methods: This is a prospective, non-comparative, multicenter observational study including diabetic patients whose HbA1c is < 9%, with visual acuity between 20/400 to 20/40 due to DME, who have undergone vitrectomy since at least 3 months before the first aflibercept injection. Treatment protocol included 5 monthly aflibercept injection followed by a ProReNata regimen during the first year. Visual acuity, OCT findings and number of IAI were assessed at 6 months and one year.Results: Forty-six eyes were included. Indications for vitrectomy were epiretinal membrane (58.7%), intravitreal hemorrhage (26.1%), and vitreomacular traction (8.7%), retinal detachment (4.3%), and other cause (4.3%). Median duration of macular edema was 3 years. Median interval between vitrectomy and first visit was 9 months. Thirty eyes were non-naïve and received previously thermal laser (44.3%), intravitreal injection of triamcinolone (26.7%), of ranibizumab (70%), of dexamethasone implant (36.7%), or bevacizumab (6.7%). Data was available for 35 eyes at 1 year. Visual gain was significant, +6 letters (p < 0.001) and central subfield thickness (CST) decreased significantly (− 108μm, p < 0.001) at 1 year. Mean number of injections was 9.3 and mean interval injection was 5.8 weeks.Conclusion: These results suggest that IAI may be beneficial in vitrectomized eyes with refractory DME which require frequent injections to obtain visual and anatomical improvement.Clinical Trial Registration: http://www.clinicaltrials.gov, registration Number NCT02874859.Keywords: aflibercept, diabetic macular edema, DME, vitrectomy, anti-VEGF