Nikolai N. Umanets, Zoya A. Rozanova (Odessa, Ukraine)

Advantages:

In cases of unsuccessful treatment of diabetic macular edema by laser or intravitreal injections of antiangiogenic factors or corticosteroids frequently we can find out posterior hyaloid or internal limiting membrane traction. In this connection to patients with a diabetic traction macular edema it was performed vitrectomy with internal limiting membrane peeling (ILM).

Methods:

Subtotal vitrectomy (20 gauge), the temporary tamponade of vitreal cavity by perfluorocarbone, ILM peeling within vascular arcades after 0,125% indocyanine green staining was carried. 10% C3F8 for a tamponade in the postoperative period was used.

Effectiveness / Safety:

Using this method 19 patient at the age from 39 till 65 years, 19 eyes, 9 proliferative diabetic retinopathies, 10 preproliferative DR were treated. Macular thickness in all patients was more than 370 microns, visual acuity less than 0,05 12 patients, 0,06-0,1 7 patients. In terms of observation till 1 year the successful anatomic result was observed at all patients, the thickness of a retina in macular area occurred 194±46ìêì. Visual acuity has raised at 17 patients, in particular, from 0,05 to 0,1 at 8 patients, 0,1-0,6 at 9 patients. In 2 cases visual acuity remained at initial level.

Complications:

4 patients had a transitional vitreous hemorrhage treated by substitutive gas tamponade, 1 patient had rhegmatogenous retinal detachment which has been treated by vitrectomy with endoretinopexy and gas (C3F8) tamponade, 1 patient had phacoemulsification with IOL. Thus, in case of a traction component at a diabetic macular edema vitrectomy with ILM peeling is effective and safe manipulation.