Benefit Of Vitrectomy And Internal Limiting Membrane Peeling In The Treatment Of Resistant Diabetic Macular Edema

Abstract

Background: To investigate the results of internal limiting membrane (ILM) peeling in patients with resistant diabetic macular edema (DME). Methods: In this randomized, controlled and prospective clinical study, the patients with resistant DME due to proliferative diabetic retinopathy were divided into two groups. Both groups underwent 23 gauge pars plana vitrectomy (PPV). Additionally ILM peeling was performed only to the cases in Group 2. During follow-ups, complete ophthalmological examinations, optical coherence tomography and fundus fluorescein angiography were performed. After PPV, intravitreal dexamethasone implant injection was performed for DME treatment when necessary. The patients were followed for 1 year. Results: A total of 40 eyes of 37 patients were included in the study. The average age was 57.5 ± 5.4 and 56.9 ± 5.8 years, and the ratio of male:female was 9:11 and 6:14 in Group 1 and Group 2, respectively (p >0.05). The improvement level in BCVA was more evident especially in the first and third months postoperatively in both groups (p <0.01). Improvement in BCVA in the first and third months postoperatively was statistically more significant in Group 2 than Group 1 (p <0.05) Conclusion:PPV is beneficial in the management of resistant DME, and ILM peeling seems to be useful for macular function and may accelerate improvement in visual acuity.