title: Efficacy of surgical removal of the internal limiting membrane in diabetic cystoid macular edema.
abstract: 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.
authors.affiliation: Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Tetsushi
authors.initials: T
authors.lastname: Kimura
authors.forename: Junichi
authors.initials: J
authors.lastname: Kiryu
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Nishiwaki
authors.forename: Hideyasu
authors.initials: H
authors.lastname: Oh
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Suzuma
authors.forename: Daisuke
authors.initials: D
authors.lastname: Watanabe
authors.forename: Masafumi
authors.initials: M
authors.lastname: Kurimoto
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Takagi
mesh_terms: 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
chemical_list: D004396:Coloring Agents; D007208:Indocyanine Green