Pars plana vitrectomy with internal limiting membrane peeling compared with intravitreal triamcinolone injection in the treatment of diabetic macular edema.
OBJECTIVE
To compare the efficacy of pars plana vitrectomy (PPV) with internal limiting membrane (ILM) removal and intravitreal triamcinolone acetonide (IVTA) injection in patients with diabetic macular edema (DME).


METHODS
This study was a retrospective, comparative, interventional case study examining 14 patients (15 eyes in total) who underwent PPV and ILM removal (vitrectomy group), and 14 patients (14 eyes in total) who were treated with an IVTA injection (triamcinolone group). Main outcome measures were visual acuity and central macular thickness at 1, 3 and 6 months postoperatively.


RESULTS
Patients in the vitrectomy group had significantly decreased central macular thicknesses at 1, 3 and 6 months postoperatively (p = 0.001, p = 0.001 and p = 0.002, respectively). The improvement in visual acuity was not significant at 1 month, but it gradually became statistically significant at 3 and 6 months after surgery (p = 0.031 and p = 0.015, respectively). Compared with the triamcinolone group, the vitrectomy group showed a better visual acuity at 6 months after surgery (p = 0.025).


CONCLUSIONS
PPV combined with ILM removal is a good therapeutic option for improving visual acuity and decreasing macular thickness in DME, and this treatment has a better long-term efficacy than a single IVTA injection.
Kim
Yong Min
YM
Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea.
Chung
Eun Jee
EJ
Byeon
Suk Ho
SH
Lee
Sung Chul
SC
Kwon
Oh Woong
OW
Koh
Hyoung Jun
HJ
D000368:Aged; D003930:Diabetic Retinopathy / Q000150:complications*; D019773:Epiretinal Membrane / Q000601:surgery; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D007267:Injections; D007429:Intraocular Pressure / Q000187:drug effects; D008266:Macula Lutea / Q000473:pathology; D008269:Macular Edema / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014222:Triamcinolone Acetonide / Q000008:administration & dosage* / Q000009:adverse effects; D014792:Visual Acuity; D014821:Vitrectomy; D014822:Vitreous Body
D005938:Glucocorticoids; D014222:Triamcinolone Acetonide