|
NR 7-9/2006
|
|
|
|
|
|
|
|
|
Witrektomia z
usunięciem błony granicznej wewnętrznej siatkówki w leczeniu
cukrzycowego obrzęku plamki
Vitrectomy with peeling
retinal limiting membrane (ILM) in eyes with diabetic macular
edema
Jolanta Oficjalska-Młyńczak1,2,
Agnieszka Jamrozy-Witkowska1,2, Maria Muzyka-Woźniak1,2,
Anna Turno-Kręcicka1, Bożena Gołębiowska2
1 Z Katedry i Kliniki Okulistyki Akademii Medycznej
we Wrocławiu
Kierownik: prof. dr hab. n. med. Maria Hanna Niżankowska
2 Z Ośrodka Okulistyki Klinicznej „Spektrum” we
Wrocławiu
Kierownik: dr n. med. Bożena Gołębiowska |
|
|
| Summary: |
Purpose: to
evaluate the efficacy of pars plana vitrectomy with
retinal internal limiting membrane (ILM) peeling in eyes
with diabetic macular edema.
Material and methods: Twenty five eyes of 25
patients with diabetic macular edema. All eyes underwent
a pars plana vitrectomy including separation of the
posterior hyaloid, ILM peeling and air endotamponde.
Preoperatively visual acuity (VA), funduscopic
examination and the presence or absence of posterior
vitreous detachment, were evaluated. Fluorescein
angiography was performed in all patients prior to
surgery. Eyes with cystoid macular edema or macular
ischaemia were excluded. Postoperative VA, anatomic
results, and complications were recorded. The follow-up
was 7 to 27 months (mean 17).
Results: Intraoperatively, thick posterior
hyaloid was found to be attached to the posterior pole
in 20 cases. The mean postoperative VA (0.2) was
significantly better than the preoperative VA (0.08)
(p=0.0001). VA improved postoperatively in 21 eyes
(84%), at least two lines on the Snellen chart in 8 eyes
(32%). It remained unchanged in 4 eyes (16%). Confluent
hard exudates in fovea were present significantly more
frequently in eyes without VA improvement (p=0.004). The
postoperative VA was better in eyes that had not
undergone photocoagulation (improvement by 0.14 line)
than in others (improvement by 0.11 line) but the
difference was non-significant. Reduction of macular
exudates was noted in every case in the follow-up over 6
months. Postoperative complication included retinal
detachment were treated by re-vitrectomy with oil
endotamponade. Cataract has been noted in six eyes.
Conclusions: Vitrectomy including removal of ILM
in diabetic macular edema, leads to improvement of
visual acuity and long-term stabilization of visual
function. |
| Słowa kluczowe: |
cukrzycowy obrzęk plamki,
witrektomia, usunięcie błony granicznej wewnętrznej
siatkówki. |
| Key words: |
diabetic macular edema,
vitrectomy, peeling of the retinal internal limiting
membrane. |
|
|
|
|
|
|
