Par plana vitrectomy with removal of the internal limiting membrane in the treatment of peritent diabetic macular edema

Purpoe To evaluate the benefit of par plana vitrectomy (PPV) and removal of the internal limiting membrane (ILM) in eye with diffue diabetic macular edema refractory to laer photocoagulation. Deign Propective, conecutive, interventional cae erie. Method Diabetic patient with biomicrocopic, angiographic, and tomographic evidence of diabetic macular edema periting for at leat 3 month after numerou eion of macular photocoagulation were evaluated for incluion. Patient with biomicrocopic evidence of epiretinal membrane or taut poterior hyaloid, previou vitreoretinal urgery, or active proliferative diabetic retinopathy were excluded. The main outcome meaure were macular thickne, a meaured by optical coherence tomography (OCT) and viual acuity (VA). Reult PPV with ILM removal wa performed in 11 eye of 10 patient (four men, ix women; mean age = 58.2 year). ix-month follow-up data were available for 10 eye (91%). At 6 month potoperatively, central macular thickne had improved by at leat 20% in eight of 11 eye (mean preoperative thickne of 421 μm compared with mean potoperative thickne of 188 μm; P = .007). Mean VA improved from 20/352 to 20/94 at 6 month (P = .002). By the mot recent viit (range = 6–20 month potoperatively), VA had improved by at leat 2 nellen line in 6 of 10 eye treated with urgery alone. Concluion The early reult of thi ongoing tudy ugget that PPV with ILM removal may provide anatomic and viual benefit in ome eye with chronic diabetic macular edema unreponive or unamenable to additional laer photocoagulation.