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ILM peeling in non tractional diabetic macular edema non responsive to standard treatment

Session Details

Session Title: Quick Fire Free Paper Session 04

Session Date/Time: Sunday 29/09/2013 | 11:00-13:00

Paper Time: 12:50

Venue: Hall C (Level 1)

First Author: M.Cereda ITALY

Co Author(s):    F. Bottoni   P. Salvetti   S. de Angelis   L. Bonavia     

Abstract Details

"Purpose:

to evaluate the effect of 25 G pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peeling in diabetic patients with clinicallly significant macular edema without evidence of vitreomacular traction no more responsive to standard therapies.

Setting:

Eye Clinic Department of Biomedical and Clinical Science ""Luigi Sacco"", Luigi Sacci Hospital Milan ITALY

Methods:

retrospective analysis of visual acuity (VA), SD-OCT (HRA+OCT Spectralis, Heidelberg Engineering GmbH, Heidelberg, Germany ) and fluorescein angiography images of 21 eyes of 21 vitrectomized patients with diagnosis of diabetic macular edema. Every patient was already submitted to intravitreal Bevacizumab and/or posterior pole laser treatment without success. We excluded patients presenting at the onset subfoveal atrophy, vitreomacular traction and/or microaneurisys suitable to laser treatment. 25 G pars plana vitrectomy with ILM peeling and cataract surgery was performed. Operations were done by 3 different surgeons (FB, MC, SdeA). Selective Argon laser on peripheral area of ischemia was performed during surgery if present. The PPV was performed after 3 months wash-out. Mean preoperative VA and CRT as well as OCT and FA features were recorded. Mean preoperative VA and CRT were compared to mean VA and CRT at 1, 3 and 6 months postOp.

Results:

14 patients have 6 months follow-up and 7 patients have 3 months follow-up. No major complications occurred during and after surgeries. Visual acuity range was beetween 0,01 and 0,5 (Mean 0,16) at baseline. Mean VA was 0,27 at 1 month follow-up (Paired T-test, P=0,03), 0,29 at 3 months and 0,35 at 6 months (P=0,02). VA was significantly higher at 6 months follow up. Central Retinal Thickness (CRT) was beetween 391 and 976 microns at baseline (Mean 653,8). Mean CRT at 1 month was 406 microns (P<0,0001), at 3 months 389 microns (P<0,0001) and 338 microns at 6 months (P<0,0001). CRT was significantly thinner at 1, 3 and 6 months of follow-up (Paired t-Test P<0,01).

Conclusions:

PPV with ILM peeling seems to be effective in diabetic patients with clinically significant macular edema no more responder to standard care to reduce retinal thickness and to improve visual acuity."

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