L. O. Hattenbach, P. N. Jentzmik, J. Puchta, Y. Sinangin, F. Koch – Klinik für Augenheilkunde, Netzhaut- und Glaskörperchirurgie, Klinikum der Johann Wolfgang Goethe Universität, Frankfurt am Main, Germany

Purpose:

To investigate visual recovery and clinical outcome after pars plana vitrectomy with or without internal limiting membrane (ILM) peeling in patients with macular edema associated with proliferative diabetic vitreoretinopathy (PDVR).

Methods:

Fourty-nine eyes of 40 patients with PDVR, diabetic macular edema and severe visual loss were included in this study. All patients underwent a 20 ga or 25 ga three-port-pars plana vitrectomy with or without indocyanine green assisted ILM peeling. We documented intraoperative and postoperative course, complications and visual outcome. Minimum follow-up time was 4 months.

Results:

By the end of the follow-up period, visual acuity was improved 2 or more lines in 18 of 49 eyes (36.7%). In 22 of 49 eyes (44.9%), final visual acuity remained unchanged (2 lines). A further decrease in visual acuity was observed in 9 eyes (18.4%). There was a tendency for those eyes that underwent ILM peeling to have better final visual recovery, although this difference did not reach statistical significance. Postoperatively, severe vitreous hemorrhage occurred in 3 of 49 eyes. Repeat vitrectomy was performed in 2 cases.

Conclusion:

Our findings suggest that vitrectomy has the potential to improve visual recovery in PDVR patients with macular edema. Combined ILM peeling may have a beneficial effect, although the true value of this surgical technique remains to be investigated.

Take-home message:

Vitrectomy is of value for an improved visual recovery in PDVR patients with macular edema. Combined ILM peeling may be beneficial in selected cases.