First Author: V.Mema ALBANIA
Co Author(s): N. Burda N. Taneja
Purpose:
To evaluate anatomic and visual acuity (VA) results of pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peeling for diffuse refractory diabetic macular edema associated with a taut premacular posterior hyaloid
Setting:
: Polyclinic of specialties Nr. 2, Ophthalmology Service, UHC Mother Teresa, Ophthalmology Department, Tertiary Eye Clinic Tirana Albania.
Methods:
Retrospective non comparative case series of patients who underwent PPV with ILM peeling for diffuse DME between January 1, 2010, and July 1, 2012, performed by a single surgeon. This case series was conducted on 25 eyes of 22 patients with diffuse refractory clinically significant diabetic macular edema, macular thickness greater than 250 ?m on optic coherence tomography (OCT) and thickened posterior hyaloid. Best-corrected visual acuity (BCVA) and macular thickness measured by OCT were evaluated preoperatively and repeated 3 and 6 months postoperatively. Macular perfusion was evaluated by fluorescein angiography, pre- and six months postoperatively.
Results:
The mean preoperative best-corrected visual acuity was 20/160, and the mean final best-corrected visual acuity was 20/80 (P < .0001, Wilcoxon signed rank test), with 14 (56%) of the 25 eyes demonstrating improvement in best-corrected visual acuity of 2 or more lines. Mean foveal thickness was 439.2 +/-106.5 microns preoperatively and 219.8 +/- 63.2 microns postoperatively (P < .002). A mean decrease in foveal thickness was found to be 219.4 +/- 127.6 microns. Eyes with macular ischemia and preoperative best-corrected visual acuity of 20/200 or less tended to respond less favorably to vitrectomy than eyes lacking these characteristics. All eyes had at least 6 months of follow-up after surgery, with a mean follow-up of 26.4 months.
Conclusions:
In eyes with persistent diffuse diabetic macular edema with a taut premacular posterior hyaloids face unresponsive to laser therapy, vitrectomy with removal of the internal limiting membrane appears to be beneficial with a reduction in DME when measured by OCT. Careful selection of eyes with favorable preoperative clinical characteristics may improve surgical outcomes.
Financial Disclosure:
None
