Purchase this article with an account.
Y. V. Baiborodov; Removal of Retinal Internal Limiting Membrane in Surgical Treatment of Diabetic Macular Edema Resistant to Laser Coagulation and to Intravitreal Kenalog Injections. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5030.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To study the efficacy of removal of retinal internal limiting membrane (ILM) in surgical treatment of diabetic macular edema resistant to both laser coagulation and intravitreal kenalog injections.
Clinical study was conducted in 22 patients diagnosed with diabetic macular edema. All patients unsuccessfully underwent laser coagulation of the macula and three intravitreal injections of kenalog with 4 month-intervals. Indication criteria for surgical treatment were unresolved macular edema at three-month time point following the third kenalog injection. Surgical procedure included standard 3-portal 25-guage vitrectomy with subsequent kenalog-contrasting and peeling of the posterior hyaloid membrane. ILM was captured and removed entirely within 4000-µm area surrounding foveola. Fluid-gas exchange concluded the procedure. Patients were followed with visometry, ophthalmoscopy and optical coherent tomography (OCT) ("Stratus" Carl Zeiss, Germany). All removed material was examined histologically to identify presence of ILM in the sample.
Within 12-month postoperative period, all patients showed significant regression of OCT-measured macular thickness and improved visual acuity as compared to the preoperative measurements. Table below shows Mean ± Standard Deviation (SD) and p values of paired t-test comparisons of preoperative versus 1-, 6- and 12-month postoperative time points for OCT-measured macular thickness and visual acuity.Histological analysis confirmed that the removed specimen in all cases represented pathologically thickened ILM.
Surgical removal of retinal ILM in patients with diabetic macular edema resistant to laser coagulation and to intravitreal kenalog injections is an effective treatment providing resolution of the edema and visual acuity improvement.
This PDF is available to Subscribers Only