Internal limiting membrane peeling effect on visual outcomes after diabetic vitrectomy

Abstract

Aim and Objectives To determine whether Internal Limiting Membrane (ILM) peeling has an effect on visual outcomes after vitrectomy for diabetic tractional retinal detachment. Settings and Design A prospective randomized interventional case series. Patients and Methods Pars Plana Vitrectomy (23-Gauge) was performed on 34 cases with diabetic epi-macular traction affecting the vision due to advanced proliferative diabetic retinopathy. The usual steps of vitrectomy were performed. The ILM was randomly chosen to be peeled in 16 cases (group I), or left not peeled in 18 cases (group II). Eventually, either air, Sulphur hexafluoride (SF6) gas or silicone oil tamponade was used. Final visual acuity results were tabulated six months after surgery, and compared between the two groups. Results The mean pre-operative visual acuity (VA) was 0.06 (decimals) and 0.03 in groups I and II respectively. The mean post-operative VA was significantly better: 0.26 and 0.27 in groups 1 and 2 respectively (P=0.001). There were no statistically significant differences between VA gains in both groups (P=0.721). Air tamponade was used in 18.8% and 33.3%, SF6 in 37.5% and 33.3%, and silicone oil in 43.8% and 33.3% in groups I and II respectively. Conclusions ILM peeling had no effect on the final visual outcome after vitrectomy for diabetic tractional retinal detachments.

Keywords

• ilm peeling
• proliferative diabetic retinopathy
• tractional retinal detachment
• vitrectomy