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G. Pertile, F. Romanelli, M. Magnani, A. Mercanti, R. Kuijepers, S. Vujosevich; Vitrectomy With Internal Limiting Membrane (ilm) Peeling in Diabetic Macular Edema: Anatomic and Functional Outcome . Invest. Ophthalmol. Vis. Sci. 2006;47(13):4638.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the anatomic and functional outcome of pars plana vitrectomy with ILM peeling in the treatment of diabetic macular edema.
72 eyes of 50 consecutive patients (20 F, 30 M) treated from October 2003 to July 2005 were included. Follow up ranged from 3.2 months to 14.8 months (mean 7,9 months).
Macular edema was evalueted using optical coherence tomography (OCT III, Zeiss); the central thickness (FT), total volume macular in the 6 mm (TMV), and the volume in the central millimetre (FV) were considered.
The presence of traction (tangential or antero–posterior) was assessed in OCT.
Mean BCVA was logMAR 0,78; the FT 442, 52 ±162,99 micrometer, the TMV 11,11 ± 3,54 mm3, the FV 0,35 ± 0,12 mm3.
54 eyes had diffuse edema (75%), 18 eyes cystoid edema (25%); 35 eyes showed vitreous traction (48,6%). Mean postop BCVA was logMAR 0,54, showing an mean improvement of 0,24 P<0,0001 (student T); the mean postop FT 301,25 ± 85,67, a mean decrease of 135,05 ± 164,93 P<0,0001; the mean TMV 8,80 ± 1,28, a mean decreas of 2,15 ± 3,00 mm3 P<0,0001; the mean FV 0,23 ± 0,06 (a mean decrease of 0,12 ± 0,12 P <0,0001).
Complications: no intraoperative complications occurred; 8 eyes showed transitory intraocular hypertension; 1 eye with severe cystoid edema developed a macular hole after 20 days that was repaired with a second operation.
Vitrectomy with ILM peeling in patients with diabetic macular edema, leads to significant anatomic and functional improvement. Moreover, eyes without traction had better functional results compared with eyes with traction, although eyes with traction had better anatomic results. References: Kimura T, Kiryu J, Nshiwaki H, et al. Efficacy of surgical removal of the internal limiting membrane in diabetic cystoid edema. Retina. 2005 Jun;25(4):454–61. Stolba U, Binder S, Gruber D, et al. Vitrectomy for persistent diffuse diabetic macular edema. Am J Ophthalmol. 2005 Aug;140(2):295–301.
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