Diabetic macular edema reduced after vitrectomy with membrane peeling

Pars plana vitrectomy with peeling of the internal limiting membrane reduced chronic diabetic macular edema in almost all eyes in a clinical study in Germany, but visual acuity did not significantly improve in more than half the eyes in the study.

Structural changes in the macula resulting from prolonged edema are the likely reason for the difference between anatomical and functional results of the procedure, the study authors said.

Patrick Dillinger and Ulrich Mester of Sulzbach, Germany, performed the prospective evaluation in 60 eyes of 55 patients with chronic diabetic macular edema. Participants had at least a 6-month history of macular edema, and all underwent pars plana vitrectomy with internal limiting membrane removal. Follow-up was a mean of 3 months, and BCVA was gathered from referring ophthalmologists at 9 months postop.

Clinical examination and fluorescein angiography showed a decrease in leakage within the macula or a decrease of macular thickening in 93% of eyes. Mean visual acuity improved from 1.05 preop to 0.87 postop. Forty-three percent of eyes gained at least two lines of vision, while 7% lost two lines.

The study is published in the August issue of Graefe’s Archive for Clinical and Experimental Ophthalmology.