Pars Plana Vitrectomy for Tractional Diabetic Macular Edema with or without Internal Limiting Membrane Peeling

Abstract

Abstract Background To assess the efficacy of pars plana vitrectomy (PPV) in management of tractional diabetic macular edema (DME) and highlight the benefits of additional internal limiting membrane (ILM) peeling. Methods This prospective study involved 50 eyes with tractional DME that underwent PPV were split into two groups: group (A) consisted of 25 eyes that did not have ILM peeling, and group (B) consisted of 25 eyes that did. One, three, and six months after surgery, a postoperative assessment was completed. Results Mean best corrected visual acuity (BCVA) in group (A) has improved from (0.89 the logarithm of minimal angle of resolution [LogMAR]) preoperatively to (0.64 LogMAR, p < 0.001), and mean central macular thickness (CMT) declined from (471.28µm) to (228.20µm, p < 0.001) after six months of PPV. In group (B), mean BCVA has improved from (0.83 LogMAR) preoperatively to (0.58 LogMAR, p < 0.001), and mean CMT decreased from (496.84µm) to (226.20µm, p < 0.001) after six months of PPV. There were no significant differences between the two groups after 1, 3, and 6 months according to the delta change % of BCVA and CMT. A significant negative correlation was detected between preoperative glycosylated hemoglobin (HbA1c) and BCVA improvement. Conclusions PPV surgery is an effective treatment of tractional DME. Additional ILM peeling is not accompanied by extra benefits in a short period. Long-term glycemic control plays a role in vision gain after vitrectomy in diabetic patients.