Effects of Internal Limiting Membrane Peeling in Vitrectomy on Diabetic Cystoid Macular Edema Patients

Kamura, Yumi; Sato, Yukihiro; Isomae, Takako; Shimada, Hiroyuki

doi:10.1007/s10384-005-0199-7

Cited by 46 publications

(23 citation statements)

References 8 publications

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“…There are three reports of ICG use in patients undergoing surgery for diabetic macular oedema. Two showed a favourable safety profile, 44,45 whereas one showed visual field defects, 42 making it difficult to draw a conclusion.…”

Section: Surgery For Diabetic Macular Oedemamentioning

confidence: 97%

Vital staining with indocyanine green: a review of the clinical and experimental studies relating to safety

Stanescu-Segall

Jackson

2008

Eye

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Indocyanine green (ICG) is extremely effective when used as a vital stain during macular hole surgery. By staining the internal limiting membrane, ICG facilitates removal of this delicate and sometimes hard to visualize structure. There is, however, considerable debate regarding its safety. This review considers the clinical and experimental studies of ICG and a related agent, infracyanine green. Some clinical papers show visual field defects, reduced visual acuity, and persistence of ICG at the macula and optic nerve. Other clinical studies fail to demonstrate toxicity. The experimental studies are also conflicting, but there are emerging trends. These suggest that surgeons who continue to use ICG should use concentrations not greater than 0.05 mg/ml, in fluid-filled eyes, with short exposure times, iso-osmolar solutions, and avoid proximal or prolonged endoillumination of stained tissue. A smaller number of studies suggest that infracyanine green produces similar staining to ICG, and may possibly be safer, but there are too few well-designed studies to reach a conclusion. Although the use of ICG continues, on the balance of evidence, this review suggests that it is has the potential to produce subtle visual damage.

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Section: Surgery For Diabetic Macular Oedemamentioning

confidence: 97%

Vital staining with indocyanine green: a review of the clinical and experimental studies relating to safety

Stanescu-Segall

Jackson

2008

Eye

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“…In recent years pars plana vitrectomy (PPV) with internal limiting membrane (ILM) removal has been reported to be beneficial in resolution of macular edema and improved visual acuity in patients with diffuse diabetic macular edema, both with and without vitreo-macular interface abnormalities [3,6,9,12]. The data from these studies included patients from potentially different prognostic groups such as presence of macular traction and taut thickened posterior hyaloid (TTPH).…”

Section: Introductionmentioning

confidence: 98%

Comparative evaluation of vitrectomy and dye-enhanced ILM peel with grid laser in diffuse diabetic macular edema

Kumar

Sinha

Azad

et al. 2006

Graefe's Arch Clin Exp Ophthalmol

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PPV with ILM peeling was shown to be beneficial by inducing a statistically significant reduction of macular thickness and macular volume. Visual acuity also demonstrated a trend towards improvement in both the ILM peel group and the grid laser group; however, the comparative VA outcome analysis between the two groups was not significantly different. Besides, there was also no correlation between the reductions of foveal thickness and macular volume with the improvement in visual acuity in either of the groups.

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“…Although several studies have reported that ILM removal enhanced the effectiveness of vitrectomy for DME [12,23,24] , there are also some reports that showed that the difference in the outcome of vitrectomy with or without ILM peeling was not significant [21,22,25] . Because ICG was used to make the ILM more visible in most of these studies, our results are consistent with those reports.…”

Section: Discussionmentioning

confidence: 99%

Triamcinolone-Assisted Removal of Internal Limiting Membrane Enhances the Effect of Vitrectomy for Diabetic Macular Edema

et al. 2009

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Purpose: To evaluate the efficacy of internal limiting membrane (ILM) peeling during vitrectomy to treat diabetic macular edema (DME). Methods: In this nonrandomized study, we retrospectively analyzed the medical charts of 107 eyes that had undergone three-port vitrectomy to treat DME. The ILM was peeled in 65 eyes and not peeled in 42 eyes (ILM ON group). Indocyanine green (ICG) was used on 36 eyes (ICG group) and triamcinolone acetonide (TA) on 29 eyes (TA group) to make the ILM more visible. Results: In all groups, the mean foveal thickness was significantly decreased after surgery. Visual acuity (VA) improved gradually after the surgery and was significantly better than the preoperative VA at 6 months in the ICG group and at 3 months in the TA group. Compared with the ILM ON group eyes, the eyes in the TA group had significantly better improvement of VA. Conclusion: TA-assisted ILM peeling may improve the VA outcome to treat DME.

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Effects of Internal Limiting Membrane Peeling in Vitrectomy on Diabetic Cystoid Macular Edema Patients

Abstract: Visual acuity improved with vitrectomy for diabetic cystoid macular edema in both groups. ILM peeling was not found to improve visual acuity postoperatively.

Cited by 46 publications

References 8 publications

Vital staining with indocyanine green: a review of the clinical and experimental studies relating to safety

Vital staining with indocyanine green: a review of the clinical and experimental studies relating to safety

Comparative evaluation of vitrectomy and dye-enhanced ILM peel with grid laser in diffuse diabetic macular edema

Triamcinolone-Assisted Removal of Internal Limiting Membrane Enhances the Effect of Vitrectomy for Diabetic Macular Edema

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