Surgical effects of internal limiting membrane peeling with vitrectomy for vitreo-macular traction in diabetic patients

Abstract

Aim: To evaluate the surgical effects of internal limiting membrane (ILM) peeling with parsplana vitrectomy in diffuse diabetic macular edema with vitreo-macular traction as regard the best corrected visual acuity, central foveal thickness, residual epiretinal membrane and recurrent traction. Methods:The study included twenty eyes of twenty patients with diffuse diabetic macular edema and vitreomacular traction. Seven eyes underwent vitrectomy with ILM peeling (group I) and thirteen eyes underwent vitrectomy without ILM (group II). The inclusion criteria were diffuse diabetic macular edema with optical coherence tomography evidence of vitreo-macular traction with or without epiretinal membrane. Exclusion criteria involved any ocular disease can cause macular edema rather than diabetes mellitus and eyes with macular ischemia.The effect of ILM peeling was evaluated on the surgical outcomes as regard best corrected visual acuity, central foveal thickness, residual epiretinal membrane and recurrent traction at postoperative one, three and six months.Results: Statistically significant improvement of best corrected visual acuity and reduction of central foveal thickness occurred in all eyes postoperatively and over time with statistically insignificant difference between both groups. No eyes in group I and eight eyes in group II showed residual epiretinal membrane with a statistically significant difference between both groups. No eyes in group I and two eyes in group II showed recurrent traction due to residual epiretinal membrane with a statistically insignificant difference between both groups. Conclusion:ILM peeling has an important role in complete removal of epiretinal membrane and prevention of recurrent traction.