Abstract
Abstract: :
Purpose: To evaluate posterior vitreous detachment (PVD) versus additional ILM–removal in DM–type II patients with diffuse/cystoid macular edema without evident vitreoretinal traction. Methods: 51 patients were included in the study. Randomization was performed intraoperatively when posterior vitreous was attached. In 20 eyes only PVD was performed (Group I), in 20 eyes additional ILM removal using ICG (Group II). In 11 eyes where the vitreous was already detached, the ILM was removed. OCT–FLA–ETDRS– microperimetry–examinations were performed preoperatively, at 3 and 6 months postoperatively. Results: Improvement of VA > 2 lines was measured in 10% of the patients (Group I), 5% (Group II) and 36% (Group III). Swtabilization could be achieved in 25% (Group I), 85% (Group II), 37% (Group III). Retinal thickness decreased in Group I from 433 µm to 413 µm, in Group II from 442 µm to 298 µm and in Group III from 501 µm to 289 µm. FLA leakage decreased in 45% (Group I), in 70% (Group II) and in 64% (Group III). Hard exsudates resolved in 31% (Group I), 59% (Group II) and 80% (Group III). Conclusion: ILM removal is more effective than vitreous detachment alone regarding reduction of retinal thickness and resolution of hard exsudates. ILM removal seems also beneficial in eyes with primarily detached vitreous. An early vitrectomy should be considered, since ILM removal seems to stabilize VA.
Keywords: diabetic retinopathy • vitreoretinal surgery • clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials