Outcomes of 25-Gauge Vitrectomy for Tractional and Nontractional Diabetic Macular Edema with Proliferative Diabetic Retinopathy

Someya, Hideaki; Takayama, Kei; Takeuchi, Masaru; Yokoyama, Hiroshi; Kimura, Takeshi; Morioka, Masakazu; Takamura, Yoshihiro; Sameshima, Seiji; Ueda, Takahiro; Ogata, Nahoko; Tashiro, Maki; Kitano, Shigehiko; Sakamoto, Taiji

doi:10.1155/2019/5304524

Cited by 16 publications

(19 citation statements)

References 37 publications

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“…The effect of internal limiting membrane (ILM) peeling on DME has also been investigated, and it has been found that this can result in a lower rate of recurrence following surgery [12]. The incidence of additional therapy following surgery has been reported as 6-20% in studies with a shorter follow-up [13,14]. Bonnin et al [15] found an incidence of 30% in their longer follow-up study.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Macular Changes in the Long Term after Pars Plana Vitrectomy with Internal Limiting Membrane Peeling for Diabetic Macular Edema

Günay

Erdoğan

2021

Ophthalmologica

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Aim: To evaluate long term macular changes following pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peeling for diabetic macular edema (DME) Methods: Forty eligible eyes of 37 patients were included in this retrospective study. Best corrected visual acuity (BCVA), central macular thickness (CMT) and 5-mm macular volume (5-MV) were examined preoperatively and at postoperative 1st, 2nd, 3rd, 6th, 12th, 24th months and final visits. Response to surgical treatment was considered as recurrence, reincrease and recovery of DME based on macular changes. Results: Mean follow-up time was 51.1±19.0 months following surgery. Recurrence (n=5) and reincrease (n=17) of DME was observed in 22 eyes (55%) and additional treatments were applied. Recovery of DME was observed in 18 eyes (45%). Preoperative and final visit mean BCVAs (logMAR) were 1.08±0.37 and 0.93±0.45, respectively (p=0.02). Preoperative and final visit mean CMTs were 514.74±155.65 µm and 281.87±112.58 µm, respectively (p<0.001). The 5-MV significantly decreased following surgery (8.18±1.57 mm3 to 6.52±1.39 mm3) (p<0.001). DME was present in 12 eyes (%30) at final visit. Conclusion: Although PPV with ILM peeling had an efficacy in DME management, this effect tends to decrease over time such that considerable amount of patients required additional treatment.

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Section: Introductionmentioning

confidence: 99%

Evaluation of Macular Changes in the Long Term after Pars Plana Vitrectomy with Internal Limiting Membrane Peeling for Diabetic Macular Edema

Günay

Erdoğan

2021

Ophthalmologica

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“…As the availability of more user-friendly microsurgical instruments and high incision speed devices increases, there is a tendency for surgical intervention to diabetic retinopathy and DME in earlier stage. PPV surgery is thought to have positive effects on DME therapy by reducing VEGF concentration in the eye and increasing oxygenation or nutrient diffusion of the retina (24,25).…”

Section: Resultsmentioning

confidence: 99%

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

Altun

Atmaca

Kanar

et al. 2021

Preprint

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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.

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“…Vitrectomy for the treatment of DME was first performed in 1992, 24 and many studies have been done since. [25][26][27][28][29] All of FIG. 1.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness and Safety of Coadministration of Intravitreal Dexamethasone Implant and Silicone Oil Endotamponade for Proliferative Diabetic Retinopathy with Tractional Diabetic Macular Edema

Altun

Kanar

Aki

et al. 2021

Journal of Ocular Pharmacology and Therapeutics

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Purpose: To investigate the efficacy and safety of coadministered intravitreal dexamethasone (IVD) implant and silicone oil endotamponade during pars plana vitrectomy (PPV) for the treatment of proliferative diabetic retinopathy (PDR) with tractional diabetic macular edema (DME). Methods: In this prospective, controlled, and randomized clinical study, the eyes with PDR and vitreomacular traction syndrome that underwent PPV with silicone oil endotamponade were divided into 2 groups. Group 1 was defined as the control group, and no other procedures were performed. IVD was implanted to the eyes in Group 2. In both groups, panretinal photocoagulation was completed to the missed areas during PPV. All cases followed for 6 months, postoperatively. Retinal findings were followed with optical coherence tomography and fluorescein fundus angiography. Results: A total of 52 eyes of 52 patients were included in the study. Twenty-six eyes of 23 patients were included in both groups. The improvement in best corrected visual acuity was statistically significantly higher in Group 2 (P > 0.05). In the postoperative period, the DME development rate and intravitreal ranibizumab (IVR) injection requirement were significantly higher in Group 1 (P > 0.05). There was no statistically significant difference in the proliferative vitroretinopathy development rate between the groups (P < 0.05). Conclusion: Coadministration of IVD implant and silicone oil endotamponade to the eyes with PDR during vitrectomy seems to be safe and effective application and may decrease the rate of DME and the requirement of IVR injection.

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Outcomes of 25-Gauge Vitrectomy for Tractional and Nontractional Diabetic Macular Edema with Proliferative Diabetic Retinopathy

Cited by 16 publications

References 37 publications

Evaluation of Macular Changes in the Long Term after Pars Plana Vitrectomy with Internal Limiting Membrane Peeling for Diabetic Macular Edema

Evaluation of Macular Changes in the Long Term after Pars Plana Vitrectomy with Internal Limiting Membrane Peeling for Diabetic Macular Edema

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

Effectiveness and Safety of Coadministration of Intravitreal Dexamethasone Implant and Silicone Oil Endotamponade for Proliferative Diabetic Retinopathy with Tractional Diabetic Macular Edema

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