Evaluation of Macular Changes in Long Term Period Following Pars Plana Vitrectomy with Internal Limiting Membrane Peeling for Diabetic Macular Edema

2021 ◽  
Author(s):  
Betul Onal Gunay ◽  
Gurkan Erdogan

Aim: To evaluate long term macular changes following pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peeling for diabetic macular edema (DME) Methods: Forty eligible eyes of 37 patients were included in this retrospective study. Best corrected visual acuity (BCVA), central macular thickness (CMT) and 5-mm macular volume (5-MV) were examined preoperatively and at postoperative 1st, 2nd, 3rd, 6th, 12th, 24th months and final visits. Response to surgical treatment was considered as recurrence, reincrease and recovery of DME based on macular changes. Results: Mean follow-up time was 51.1±19.0 months following surgery. Recurrence (n=5) and reincrease (n=17) of DME was observed in 22 eyes (55%) and additional treatments were applied. Recovery of DME was observed in 18 eyes (45%). Preoperative and final visit mean BCVAs (logMAR) were 1.08±0.37 and 0.93±0.45, respectively (p=0.02). Preoperative and final visit mean CMTs were 514.74±155.65 µm and 281.87±112.58 µm, respectively (p<0.001). The 5-MV significantly decreased following surgery (8.18±1.57 mm3 to 6.52±1.39 mm3) (p<0.001). DME was present in 12 eyes (%30) at final visit. Conclusion: Although PPV with ILM peeling had an efficacy in DME management, this effect tends to decrease over time such that considerable amount of patients required additional treatment.

2007 ◽  
Vol 51 (4) ◽  
pp. 285-291 ◽  
Author(s):  
Teiko Yamamoto ◽  
Shinobu Takeuchi ◽  
Yukihiro Sato ◽  
Hidetoshi Yamashita

2020 ◽  
Author(s):  
Aliagha Alishiri ◽  
Hamidreza Torabi ◽  
Khosrow Jadidi ◽  
Seyed Aliasghar Mosavi

Abstract Purpose: Evaluating the impact of pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peeling and intravitreal bevacizumab (IVB) injection to manage refractory diffuse diabetic macular edema (DME).Methods: In the current prospective interventional clinical study, eyes with refractory diffuse DME with no response to a minimum of three times IVB injections, and best corrected visual acuity (BCVA) of equal or more than 20/200 and equal or lower than 20/60 were subjected to PPV with ILM peeling and intravitreal avastin injection. Pre- and post-operative assessments were a comprehensive ophthalmologic evaluation, fluorescein angiography, and optical coherence tomography (OCT). BCVA, central macular thickness (CMT) and contrast sensitivity (CS) were major outcomes. Results: Fifteen eyes of 13 cases (mean age: 63±5.19 (range, 54-70) years) were subjected to operation and a follow-up of 3 months. Average BCVA at last test was 0.74 ± 0.19 LogMAR that showed no improvement compared with its value before intervention (0.84 ± 0.14 LogMAR) (P=0.073). Average CMT at last test was 328.26±129 µm that was significantly lower compared with its value before operation (450.8±114 µm) (P=0.002) and a significant improvement in CS was found (from 16.66 ± 8.99 mm to 18.13 ±1.22mm;p=0.003). CMT and BCVA (correlation coefficient =0.419,p=0.120), BCVA and CS (correlation coefficient =-0.336,p=0.221) , and CS and CMT (correlation coefficient =-0.07,p=0.979) were found with no significant correlation. Conclusion: PPV with ILM peeling and IVB regarding refractory diffuse DME reduced macular width along with CS improvement, but does not significantly improve visual acuity.


2021 ◽  
Vol 11 (3) ◽  
pp. 926
Author(s):  
Max Philipp Brinkmann ◽  
Stephan Michels ◽  
Carolin Brinkmann ◽  
Mario Damiano Toro ◽  
Nicole Graf Johansen ◽  
...  

Background: Previous studies have shown that epiretinal membranes (ERMs) may be associated with abnormal outer retinal anatomy. However, long-term morphological and functional results of pars plana vitrectomy (PPV) with ERM and internal limiting membrane (ILM) peeling in eyes with central bouquet (CB) alterations have not yet been investigated. Methods: In a retrospective, consecutive study all patients underwent best corrected visual acuity (BCVA) testing and spectral domain optical coherence tomography (SD-OCT) before and after a mean of 20 months (range 3–70 months) postoperatively. CB abnormalities and ERMs were classified according to Govetto’s staging systems. Results: Of the 67 eyes, 22 (34%) showed CB abnormalities at baseline. The mean BCVA increased from 0.42 at baseline to 0.20 LogMAR at final follow-up (p < 0.001). Neither ERM stage (p = 0.06) nor CB stage (p = 0.939) at baseline were significant predictors of vision improvement following surgery. Conclusions: Our results show that baseline BCVA, but not classification of CB changes and ERM at baseline, seems to be a useful predictor for functional outcomes following PPV with ERM and ILM peeling in the long-term.


2015 ◽  
Vol 2015 ◽  
pp. 1-10 ◽  
Author(s):  
Hanhan Liu ◽  
Shanru Zuo ◽  
Chun Ding ◽  
Xunzhang Dai ◽  
Xiaohua Zhu

We conducted a meta-analysis of published retrospective studies and compared the effectiveness of pars plana vitrectomy with and without internal limiting membrane (ILM) peeling for idiopathic epiretinal membrane (IERM). The results revealed that patients in the IERM+ILM peeling group had better BCVA after surgery within 12 months than those in IERM peeling group. But patients in the IERM peeling group showed better BCVA in the 18th month. More retrospective studies or randomized controlled trials are required to investigate and compare the long-term effect of IERM removal with and without ILM peeling.


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