有无内界膜剥除的弥漫性糖尿病性黄斑水肿的玻璃体切除术结果
Vitrectomy results for diffuse diabetic macular edema with and without inner limiting membrane removal.
作者信息
Stefaniotou M, Aspiotis M, Kalogeropoulos C, Christodoulou A, Psylla M, Ioachim E, Alamanos I, Psilas K
机构信息
University Eye Clinic of Ioannina, Medical School University of Ioannina, Ioannina, Greece.
出版信息
Eur J Ophthalmol. 2004 Mar-Apr;14(2):137-43. doi: 10.1177/112067210401400209.
PURPOSE
To determine whether vitrectomy for diffuse diabetic macular edema with and without internal limiting membrane (ILM) peeling is equally effective in reducing edema.
METHODS
The authors retrospectively analyzed the surgical outcomes in 73 eyes of 52 patients with diffuse diabetic macular edema. Eighteen eyes (Group A) underwent three-port pars plana vitrectomy with posterior hyaloid membrane (PHM) removal, while 55 eyes (Group B) had pars plana vitrectomy with additional ILM peeling after PHM removal.
RESULTS
Intraoperatively, the posterior hyaloid was found to be attached to the macula in all eyes. In Group A, macular edema resolved completely in 8 eyes (44.4%) with improvement of visual acuity (VA). In Group B, VA improved in 38 eyes (69.1%) with complete resolution of edema. The results of this study indicated that vitrectomy effectively reduced macular edema but eyes with ILM peeling (Group B) presented better results than those without ILM peeling. Another important factor related to the outcome seems to be the level of glycosylated hemoglobin (HbA1c).
CONCLUSIONS
In eyes with diffuse diabetic macular edema vitrectomy seems to be effective, but additional ILM peeling presented better results.
目的
确定玻璃体切除术治疗伴有或不伴有内界膜（ILM）剥除的弥漫性糖尿病性黄斑水肿在减轻水肿方面是否同样有效。
方法
作者回顾性分析了52例弥漫性糖尿病性黄斑水肿患者73只眼的手术结果。18只眼（A组）接受了三通道平坦部玻璃体切除术并切除后玻璃体膜（PHM），而55只眼（B组）在切除PHM后进行了平坦部玻璃体切除术并附加ILM剥除。
结果
术中发现所有眼中后玻璃体膜均附着于黄斑。A组中，8只眼（44.4%）黄斑水肿完全消退，视力（VA）提高。B组中，38只眼（69.1%）VA提高，水肿完全消退。本研究结果表明，玻璃体切除术能有效减轻黄斑水肿，但接受ILM剥除的眼（B组）比未接受ILM剥除的眼效果更好。另一个与结果相关的重要因素似乎是糖化血红蛋白（HbA1c）水平。
结论
对于弥漫性糖尿病性黄斑水肿的眼，玻璃体切除术似乎有效，但附加ILM剥除效果更好。
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