ILM-REMOVAL IN PATIENTS WITH MACULAR EDEMA AND DIABETES TYPE II WITHOUT EVIDENT VITREOUS TRACTION

Hans Hoerauf, M. Müller, J. Winkler, M. Muecke, H. Laqua (Luebeck)

Purpose: Pars plana vitrectomy with posterior vitreous detachment (PVD) has been proven to be successful in diabetic macular edema with thickened posterior hyaloid. The aim of this retrospective study was to evaluate the influence of ILM-removal on diffuse and cystoid macular edema without evident vitreous traction.

Patients+Methods: 29 eyes of 27 patients (16f, 11m; mean age: 66.1years) under-went vitrectomy with ILM-peeling. In 13 eyes the posterior vitreous was already detached, in 16 eyes PVD was induced surgically. ILM-removal was confirmed by electron microscopy.

Results: Visual acuity improved in 9 eyes (> two lines in 1 eye), remained unchanged in 14 eyes and worsened in 6 eyes. In fluorescein angiography leakage decreased significantly in 3/16 eyes, slightly in 5/16 eyes and remained unchanged in 6/16 eyes. No correlation was found between visual outcome or leak-age and induction of PVD. Complications included iatrogenic retinal tears (6 eyes) and retinal detachment (1 eye); none of the eyes had loss of visual acuity due to these complications.

Conclusion: In this heterogenous group of patients with advanced stages of macular edema and no evident vitreous traction, vitrectomy with ILM-removal was beneficial in selected cases. Prospective studies are need-ed to better define the prognostic factors for visual outcome.


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