ABSTRACT
@#AIM: To observe the clinical effect of 25G vitrectomy combined with inner limiting membrane(ILM)peeling in the treatment of severe proliferative diabetic retinopathy(PDR)with macular displacement.<p>METHODS: Clinical data of 36 cases(36 eyes), diagnosed as severe proliferative diabetic retinopathy with macular displacement in Jiangsu Province Hospital were collected. Eighteen cases admitted from January to December 2016 were included in the control group(18 eyes, treated by 25G vitrectomy), while 18 cases admitted from January to December 2017 were included in the combined group(18 eyes, treated by 25G vitrectomy with ILM peeling). Best corrected visual acuity(BCVA), intraocular pressure(IOP), complications, and the thickness of macular center area(CMT)were examined during follow-up at 7d, 1mo, 3mo and 6mo postoperative.<p>RESULTS: BCVA showed a significant improvement at postoperative 6mo compared with baseline in both groups <i>(P</i><0.05). CMT of the combination group was thinner than that of the control group(<i>P</i><0.001). Two eyes(11%)had intraocular hypertension,and 1 eye(6%)had macular edema in the combined group, while post-operative complications included intraocular hypertension(6%),macular membrane(6%)and vitreous hemorrhage(6%)in the control group. No statistical difference was found in the complication rates between the two groups(all <i>P</i>=1.000).<p>CONCLUSION: In the treatment of severe PDR with macular displacement, 25G vitrectomy combined with ILM peeling can effectively and safely improve visual acuity and reduce the thickness of macular center area.
ABSTRACT
PURPOSE: To compare vascular displacement in the macula after surgical closure of idiopathic macular hole (MH) after single-layered inverted internal limiting membrane (ILM) flap technique and conventional ILM removal. METHODS: This retrospective study included patients who underwent either vitrectomy and ILM removal only or vitrectomy with single-layered inverted ILM flap for idiopathic MH larger than 400 µm from 2012 to 2015. A customized program compared the positions of the retinal vessels in the macula between preoperative and postoperative photographs. En face images of 6 × 6 mm optical coherence tomography volume scans were registered to calculate the scale. Retinal vessel displacement was measured as a vector value by comparing its location in 16 sectors of a grid partitioned into eight sectors in two rings (inner, 2 to 4 mm; outer, 4 to 6 mm). The distance and angle of displacement were calculated as an average vector and were compared between the two groups for whole sectors, inner ring, outer ring, and for each sector. RESULTS: Twenty patients were included in the ILM flap group and 22 in the ILM removal group. There were no statistical differences between the groups for baseline characteristics. The average displacement in the ILM flap group and the ILM removal group was 56.6 µm at −3.4° and 64.9 µm at −2.7°, respectively, for the whole sectors (p = 0.900), 76.1 µm at −1.1° and 87.3 µm at −0.9° for the inner ring (p = 0.980), and 37.4 µm at −8.2° and 42.7 µm at −6.3° for the outer ring (p = 0.314). There was no statistical difference in the displacement of each of the sectors. CONCLUSIONS: Postoperative topographic changes showed no significant differences between the ILM flap and the ILM removal group for idiopathic MH. The single-layered ILM flap technique did not appear to cause additional displacement of the retinal vessels in the macula.