Role of internal limiting membrane peeling for cases of recalcitrant diabetic macular edema

Background/Aims: To investigate the efficacy of internal limiting membrane (ILM) peeling following pars plana vitrectomy for cases of recalcitrant diabetic macular edema in terms of improved visual acuity and reduced central macular thickness (CMT). Materials and Methods: A prospective randomized in...

Full description

Bibliographic Details
Main Authors: Sujit Das, Rakesh Maggon
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2017-01-01
Series:Kerala Journal of Ophthalmology
Subjects:
Online Access:http://www.kjophthal.com/article.asp?issn=0976-6677;year=2017;volume=29;issue=3;spage=192;epage=196;aulast=Das
_version_ 1819267621031247872
author Sujit Das
Rakesh Maggon
author_facet Sujit Das
Rakesh Maggon
author_sort Sujit Das
collection DOAJ
description Background/Aims: To investigate the efficacy of internal limiting membrane (ILM) peeling following pars plana vitrectomy for cases of recalcitrant diabetic macular edema in terms of improved visual acuity and reduced central macular thickness (CMT). Materials and Methods: A prospective randomized interventional study of 60 eyes with recalcitrant diabetic macular edema between age groups of 30–75 years of either sex were included if they are unresponsive to at least one intravitreal steroid after 4 weeks followed by at least one intravitreal antivascul©ar endothelial growth factors followed by conventional laser treatment after 8 weeks at least within or <8 weeks before enrollment into the study. The absence of macular ischemia and CMT of more than 350 μ were included. The main outcome measures were corrected and uncorrected visual acuity, reduction of CMT, early and postoperative complications, and intraocular pressure. Results: The mean (standard deviation [SD]) of coherence tomography (OCT) was 558.3 (74.2) and 537.6 (52.6) in ILM and non-ILM group, respectively. On day 1, OCT was reduced to 419.0 in ILM peeling group (558.3–419.0, P< 0.001, statistically significant) and increased to 543.8 in non-ILM peeling group (537.6–543.8, P = 0.002, statistically significant) from baseline. The mean (SD) of best-corrected visual acuity (BCVA) at baseline in ILM peeling and non-ILM peeling were 1.24 (0.15) and 1.27 (0.15), respectively. The reduction in mean of BCVA at 6 and 12 weeks from baseline (1.24–1.16, P = 0.010 and 1.24–1.15, P = 0.014) was found to be statistically significant in ILM peeling whereas there is no change in the mean BCVA over 12 weeks. Conclusion: ILM peeling gives satisfactory results in recalcitrant diabetic macular edema.
first_indexed 2024-12-23T21:20:04Z
format Article
id doaj.art-c1472ba349a94c4daa4e75c1c6f254a5
institution Directory Open Access Journal
issn 0976-6677
language English
last_indexed 2024-12-23T21:20:04Z
publishDate 2017-01-01
publisher Wolters Kluwer Medknow Publications
record_format Article
series Kerala Journal of Ophthalmology
spelling doaj.art-c1472ba349a94c4daa4e75c1c6f254a52022-12-21T17:30:47ZengWolters Kluwer Medknow PublicationsKerala Journal of Ophthalmology0976-66772017-01-0129319219610.4103/kjo.kjo_96_17Role of internal limiting membrane peeling for cases of recalcitrant diabetic macular edemaSujit DasRakesh MaggonBackground/Aims: To investigate the efficacy of internal limiting membrane (ILM) peeling following pars plana vitrectomy for cases of recalcitrant diabetic macular edema in terms of improved visual acuity and reduced central macular thickness (CMT). Materials and Methods: A prospective randomized interventional study of 60 eyes with recalcitrant diabetic macular edema between age groups of 30–75 years of either sex were included if they are unresponsive to at least one intravitreal steroid after 4 weeks followed by at least one intravitreal antivascul©ar endothelial growth factors followed by conventional laser treatment after 8 weeks at least within or <8 weeks before enrollment into the study. The absence of macular ischemia and CMT of more than 350 μ were included. The main outcome measures were corrected and uncorrected visual acuity, reduction of CMT, early and postoperative complications, and intraocular pressure. Results: The mean (standard deviation [SD]) of coherence tomography (OCT) was 558.3 (74.2) and 537.6 (52.6) in ILM and non-ILM group, respectively. On day 1, OCT was reduced to 419.0 in ILM peeling group (558.3–419.0, P< 0.001, statistically significant) and increased to 543.8 in non-ILM peeling group (537.6–543.8, P = 0.002, statistically significant) from baseline. The mean (SD) of best-corrected visual acuity (BCVA) at baseline in ILM peeling and non-ILM peeling were 1.24 (0.15) and 1.27 (0.15), respectively. The reduction in mean of BCVA at 6 and 12 weeks from baseline (1.24–1.16, P = 0.010 and 1.24–1.15, P = 0.014) was found to be statistically significant in ILM peeling whereas there is no change in the mean BCVA over 12 weeks. Conclusion: ILM peeling gives satisfactory results in recalcitrant diabetic macular edema.http://www.kjophthal.com/article.asp?issn=0976-6677;year=2017;volume=29;issue=3;spage=192;epage=196;aulast=DasDiabetic macular edemadiabetic retinopathyrecalcitrant diabetic macular edema
spellingShingle Sujit Das
Rakesh Maggon
Role of internal limiting membrane peeling for cases of recalcitrant diabetic macular edema
Kerala Journal of Ophthalmology
Diabetic macular edema
diabetic retinopathy
recalcitrant diabetic macular edema
title Role of internal limiting membrane peeling for cases of recalcitrant diabetic macular edema
title_full Role of internal limiting membrane peeling for cases of recalcitrant diabetic macular edema
title_fullStr Role of internal limiting membrane peeling for cases of recalcitrant diabetic macular edema
title_full_unstemmed Role of internal limiting membrane peeling for cases of recalcitrant diabetic macular edema
title_short Role of internal limiting membrane peeling for cases of recalcitrant diabetic macular edema
title_sort role of internal limiting membrane peeling for cases of recalcitrant diabetic macular edema
topic Diabetic macular edema
diabetic retinopathy
recalcitrant diabetic macular edema
url http://www.kjophthal.com/article.asp?issn=0976-6677;year=2017;volume=29;issue=3;spage=192;epage=196;aulast=Das
work_keys_str_mv AT sujitdas roleofinternallimitingmembranepeelingforcasesofrecalcitrantdiabeticmacularedema
AT rakeshmaggon roleofinternallimitingmembranepeelingforcasesofrecalcitrantdiabeticmacularedema