Wang L, Chen CJ, Wang ML, Huang Y, Fang LJ. Effects of vitrectomy combined with internal limiting membrane peeling in patients with diabetic macular edema. World J Clin Cases 2024; 12(21): 4491-4498 [DOI: 10.12998/wjcc.v12.i21.4491]
Corresponding Author of This Article
Li-Jian Fang, Doctor, Associate Chief Physician, Department of Ophthalmology, Liangxiang Hospital of Beijing Fangshan District, No. 45 Gongchen Street, Liangxiang, Fangshan District, Beijing 102400, China. lijianf2023321@163.com
Research Domain of This Article
Orthopedics
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Jul 26, 2024; 12(21): 4491-4498 Published online Jul 26, 2024. doi: 10.12998/wjcc.v12.i21.4491
Effects of vitrectomy combined with internal limiting membrane peeling in patients with diabetic macular edema
Lei Wang, Chun-Jie Chen, Ming-Li Wang, Yong Huang, Li-Jian Fang
Lei Wang, Chun-Jie Chen, Ming-Li Wang, Yong Huang, Li-Jian Fang, Department of Ophthalmology, Liangxiang Hospital of Beijing Fangshan District, Beijing 102400, China
Author contributions: Wang L designed the research and wrote the first manuscript; Wang L, Chen CJ, Wang ML, Huang Y and Fang LJ contributed to conceiving the research and analyzing data; Wang L and Fang LJ conducted the analysis and provided guidance for the research; all authors reviewed and approved the final manuscript.
Supported byYouth Project of Liangxiang Hospital Fangshan District Beijing, No. 2022-11.
Institutional review board statement: This study was approved by the Ethic Committee of Liangxiang Hospital of Beijing Fangshan District.
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrollment.
Conflict-of-interest statement: All the authors declare that they have no conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Li-Jian Fang, Doctor, Associate Chief Physician, Department of Ophthalmology, Liangxiang Hospital of Beijing Fangshan District, No. 45 Gongchen Street, Liangxiang, Fangshan District, Beijing 102400, China. lijianf2023321@163.com
Received: March 1, 2024 Revised: April 29, 2024 Accepted: May 15, 2024 Published online: July 26, 2024 Processing time: 120 Days and 22.3 Hours
Abstract
BACKGROUND
Diabetic macular edema (DME), a chronic microvascular complication of diabetes, is a leading cause of visual impairment and blindness. Pars plana vitrectomy (PPV) can restore the normal macular structure and reduce macular edema, whereas internal limiting membrane (ILM) peeling is used to treat tractional macular diseases. Despite the advantages, there is limited research on the combined effects of PPV with ILM peeling.
AIM
To observe the effects of PPV combined with ILM peeling on postoperative central macular thickness (CMT), best-corrected visual acuity (BCVA), cystoid macular edema (CME) volume, and complications in patients with DME.
METHODS
Eighty-one patients (92 eyes) diagnosed with DME at the Beijing Shanqu Liangxiang Hospital between January and December 2022 were randomly divided to undergo PPV alone (control group: 41 patients, 47 eyes) or PPV + ILM peeling (stripping group: 40 patients, 45 eyes); a single surgeon performed all surgeries. The two groups were compared preoperatively and 1 and 3 months postoperatively.
RESULTS
Preoperatively, both groups had comparable values of CMT, BCVA, and CME volume (P > 0.05). After surgery (both 1 and 3 months), both groups showed significant reductions in CMT, BCVA, and CME volume compared to preoperative levels, with the stripping group showing more significant reductions compared to the control group (P < 0.05). Further repeated-measures ANOVA analysis for within-group differences revealed significant effects of group and time, and interaction effects for CMT, BCVA, and CME volume (P < 0.05). There were no significant differences in the incidence of complications between the groups (retinal detachment: control = 2, stripping = 1; endophthalmitis: Control = 4, stripping = 1; no cases of secondary glaucoma or macular holes; χ2 = 0.296, P = 0.587).
CONCLUSION
PPV with ILM peeling can significantly improve the visual acuity of patients with DME, reduce CMT, and improve CME with fewer complications.
Core Tip: This study investigates the effectiveness of combining vitrectomy with internal limiting membrane peeling in treating patients with diabetic macular edema (DME). We found that this combined approach aids in the early reduction of DME, decreases central macular thickness, and positively affects visual recovery. Further long-term observations are required to assess the impact on complications.
