Pars plana vitrectomy and removal of the internal limiting membrane in the treatment of chronic macular oedema.
BACKGROUND
To evaluate the results of pars plana vitrectomy with peeling of the internal limiting membrane (ILM) in eyes with chronic macular oedema.


METHODS
PPV with indocyanine green (ICG) assisted peeling of the ILM was performed in 33 eyes with diabetic (21 eyes) or non-diabetic (12 eyes) macular oedema. Postoperatively, resolution of macular oedema, improvement of visual acuity (VA) and complications were documented. The peeled membranes were submitted for light and transmission electron microscopic evaluation.


RESULTS
The mean follow-up time was 12.2 months. The macular oedema decreased or was resolved in 17 (81%) eyes in the diabetic group and in 11 (92%) eyes in the non-diabetic group. VA improved by at least 2 lines in 11 (52%) eyes in the diabetic group and in 7 (58%) eyes in the non-diabetic group. The difference between visual acuity improvements of the two groups was not statistically significant (P>0.05). However, in the diabetic group the difference of visual improvement between cystoid and diffuse type of macular oedema eyes was statistically significant (14% versus 71%, P=0.02). Light and transmission electron microscopy showed the presence of ILM in all specimens. During the follow-up period no recurrence of macular oedema or epiretinal membrane formation was observed.


CONCLUSIONS
Pars plana vitrectomy with peeling of the ILM and epiretinal membrane leads to the resolution of macular oedema in the majority of eyes. This however, is not always associated with VA improvement. In diabetic eyes, cystoid type of macular oedema appears to be a poor prognostic factor for improved VA.
Avci
Remzi
R
Department of Ophthalmology, Uludag University Faculty of Medicine, 16059 Gorukle Bursa, Turkey. ravci@uludag.edu.tr
Kaderli
Berkant
B
Avci
Berrin
B
Simsek
Saban
S
Baykara
Mehmet
M
Kahveci
Zeynep
Z
Gelisken
Oner
O
Yucel
Ahmet Ali
AA
D000328:Adult; D000368:Aged; D001485:Basement Membrane / Q000601:surgery / Q000648:ultrastructure; D002908:Chronic Disease; D004396:Coloring Agents; D003930:Diabetic Retinopathy / Q000601:surgery*; D019773:Epiretinal Membrane / Q000473:pathology / Q000601:surgery*; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007208:Indocyanine Green; D008269:Macular Edema / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014792:Visual Acuity; D014821:Vitrectomy
D004396:Coloring Agents; D007208:Indocyanine Green