Pars Plana Vitrectomy with Internal Limiting Membrane Peeling for Refractory Diffuse Diabetic Macular Edema
Purpose: To evaluate the effect of pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peeling for management of refractory diffuse diabetic macular edema (DME). Methods: In this prospective interventional case series, eyes with refractory diffuse DME unresponsive to macular photocoag...
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2010-01-01
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doaj-fbed61b19aba4f83be51710f4e55ffe72020-11-25T02:20:20ZengKnowledge EJournal of Ophthalmic & Vision Research2008-322X2010-01-0153162167Pars Plana Vitrectomy with Internal Limiting Membrane Peeling for Refractory Diffuse Diabetic Macular EdemaMohammad-Hossein DehghanMasoud SalehipourJalil NaghibMahnaz BabaeianSaeed KarimiMehdi YaseriPurpose: To evaluate the effect of pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peeling for management of refractory diffuse diabetic macular edema (DME). Methods: In this prospective interventional case series, eyes with refractory diffuse DME unresponsive to macular photocoagulation and/or intravitreal bevacizumab, and best corrected visual acuity (BCVA) ≥20/200 and ≤20/60 underwent triamcinoloneassisted PPV with ILM peeling. Pre- and postoperative evaluations included a complete ophthalmologic examination, fluorescein angiography and optical coherence tomography (OCT). Main outcome measures were BCVA and central macular thickness (CMT). Results: Twelve eyes of 12 patients with mean age of 59.6±3.9 (range, 55-68) years were operated and followed for a mean period of 4.9±1.0 (range, 4-6) months. Mean BCVA at final examination was 0.82 ± 0.18 logMAR which was not significantly better than its preoperative value of 1.00 ± 0.80 logMAR (P=0.959). Visual acuity improved by at least 2 lines in 3 eyes (25%), remained stable in 7 eyes (58%) and decreased by at least 2 lines in 2 eyes (17%). Mean CMT at final examination was 315±95 μm, which was significantly less than its preoperative value of 467±107 μm (P=0.004). Complications included vitreous hemorrhage in 2 and cataract progression in 5 eyes. Conclusion: PPV with ILM peeling for refractory diffuse DME seems to reduce macular thickness, but does not significantly improve visual acuity as observed after an intermediate-term follow up of about 6 months.http://www.jovr.org/article.asp?issn=2008-322X;year=2010;volume=5;issue=3;spage=162;epage=167;aulast=DehghanPars Plana Vitrectomy; Internal Limiting Membrane; Macular Edema; Central Macular Thickness |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Mohammad-Hossein Dehghan Masoud Salehipour Jalil Naghib Mahnaz Babaeian Saeed Karimi Mehdi Yaseri |
spellingShingle |
Mohammad-Hossein Dehghan Masoud Salehipour Jalil Naghib Mahnaz Babaeian Saeed Karimi Mehdi Yaseri Pars Plana Vitrectomy with Internal Limiting Membrane Peeling for Refractory Diffuse Diabetic Macular Edema Journal of Ophthalmic & Vision Research Pars Plana Vitrectomy; Internal Limiting Membrane; Macular Edema; Central Macular Thickness |
author_facet |
Mohammad-Hossein Dehghan Masoud Salehipour Jalil Naghib Mahnaz Babaeian Saeed Karimi Mehdi Yaseri |
author_sort |
Mohammad-Hossein Dehghan |
title |
Pars Plana Vitrectomy with Internal Limiting Membrane Peeling for Refractory Diffuse Diabetic Macular Edema |
title_short |
Pars Plana Vitrectomy with Internal Limiting Membrane Peeling for Refractory Diffuse Diabetic Macular Edema |
title_full |
Pars Plana Vitrectomy with Internal Limiting Membrane Peeling for Refractory Diffuse Diabetic Macular Edema |
title_fullStr |
Pars Plana Vitrectomy with Internal Limiting Membrane Peeling for Refractory Diffuse Diabetic Macular Edema |
title_full_unstemmed |
Pars Plana Vitrectomy with Internal Limiting Membrane Peeling for Refractory Diffuse Diabetic Macular Edema |
title_sort |
pars plana vitrectomy with internal limiting membrane peeling for refractory diffuse diabetic macular edema |
publisher |
Knowledge E |
series |
Journal of Ophthalmic & Vision Research |
issn |
2008-322X |
publishDate |
2010-01-01 |
description |
Purpose: To evaluate the effect of pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peeling for management of refractory diffuse diabetic macular edema (DME).
Methods: In this prospective interventional case series, eyes with refractory diffuse DME unresponsive to macular photocoagulation and/or intravitreal bevacizumab, and best corrected visual acuity (BCVA) ≥20/200 and ≤20/60 underwent triamcinoloneassisted PPV with ILM peeling. Pre- and postoperative evaluations included a complete ophthalmologic examination, fluorescein angiography and optical coherence tomography (OCT). Main outcome measures were BCVA and central macular thickness (CMT).
Results: Twelve eyes of 12 patients with mean age of 59.6±3.9 (range, 55-68) years were operated and followed for a mean period of 4.9±1.0 (range, 4-6) months. Mean BCVA at final examination was 0.82 ± 0.18 logMAR which was not significantly better than its preoperative value of 1.00 ± 0.80 logMAR (P=0.959). Visual acuity improved by at least 2 lines in 3 eyes (25%), remained stable in 7 eyes (58%) and decreased by at least 2 lines in 2 eyes (17%). Mean CMT at final examination was 315±95 μm, which was significantly less than its preoperative value of 467±107 μm (P=0.004). Complications included vitreous hemorrhage in 2 and cataract progression in 5 eyes.
Conclusion: PPV with ILM peeling for refractory diffuse DME seems to reduce macular thickness, but does not significantly improve visual acuity as observed after an intermediate-term follow up of about 6 months. |
topic |
Pars Plana Vitrectomy; Internal Limiting Membrane; Macular Edema; Central Macular Thickness |
url |
http://www.jovr.org/article.asp?issn=2008-322X;year=2010;volume=5;issue=3;spage=162;epage=167;aulast=Dehghan |
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