Efficacy of surgical removal of the internal limiting membrane in diabetic cystoid macular edema.
OBJECTIVE
To evaluate the efficacy of surgical removal of the internal limiting membrane (ILM) in diabetic cystoid macular edema (CME).


METHODS
Prospective, noncomparative, interventional case series including 21 eyes of 18 consecutive patients with diabetic CME. Vitrectomy with separation of the posterior hyaloid and induction of posterior vitreous detachment had been performed previously on nine eyes. Pars plana vitrectomy for removal of the ILM was performed.


RESULTS
CME resolved in eyes that underwent initial vitrectomy and in those with long-standing (>1 year) CME after previous vitrectomy. Postoperative best-corrected visual acuity improved by >/=2 lines of a Snellen equivalent in 14 eyes (67%) (P < 0.01). The mean foveal thickness (distance between the inner retinal surface and the retinal pigment epithelium) decreased from 553 microm to 221 microm at 4 weeks (P < 0.001). No recurrences or deterioration of CME was observed during the entire follow-up period (mean, 17.8 months; range, 8-34 months).


CONCLUSIONS
Surgical removal of the ILM might be an effective procedure for reducing CME in patients with diabetes. A prospective, randomized, controlled study is necessary to further evaluate the efficacy of the procedure.
Kimura
Tetsushi
T
Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Kiryu
Junichi
J
Nishiwaki
Hirokazu
H
Oh
Hideyasu
H
Suzuma
Kiyoshi
K
Watanabe
Daisuke
D
Kurimoto
Masafumi
M
Takagi
Hitoshi
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001485:Basement Membrane / Q000601:surgery; D004396:Coloring Agents; D003930:Diabetic Retinopathy / Q000601:surgery*; D019773:Epiretinal Membrane / Q000601:surgery; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007208:Indocyanine Green; D008269:Macular Edema / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014792:Visual Acuity; D014821:Vitrectomy
D004396:Coloring Agents; D007208:Indocyanine Green