Abstract
Purpose: :
To evaluate anatomic and visual acuity (VA) results of pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peeling for diffuse diabetic macular edema (DME).
Methods: :
Retrospective non–comparative case series of patients who underwent PPV with ILM peeling for diffuse DME between January 1, 2000 and July 1, 2005 performed by 3 separate surgeons at Bascom Palmer Eye Institute. Main outcome measures included pre– and postoperative OCT and visual acuity. Mean follow–up period was 7 months (range 43 days – 2 years).
Results: :
Twenty–three patients meeting the criteria were evaluated. Duration of DME ranged from 1–93 months. Of patients with pre– and postoperative OCT, there was an overall reduction in central macular thickness (mean improvement – 158 microns at postoperative month 3 and 103 microns at last follow–up). Mean visual acuity was 20/160 (range 20/40 – 4/200) preoperatively and 20/125 (range 20/30 – 2/200) at last follow–up. At last follow–up, 26% of patients had ≥ 2 line increase in VA from baseline, 52% of patients had stable VA, and 22% of patients had ≥ 2 line decrease in VA. Postoperative complications included progression of cataract in 5/12 phakic patients, postoperative IOP ≥ 30 mm Hg in 4 patients, and postoperative vitreous hemorrhage in 1 patient.
Conclusions: :
Pars plana vitrectomy with internal limiting membrane peeling was associated with decreased diabetic macular edema as measured by OCT in the majority of patients, but visual outcomes showed minimal improvement.
Keywords: diabetes • macula/fovea • diabetic retinopathy