Evaluation of Pars Plana Vitrectomy with ILM Peeling in Management of Persistent Nontractional Diabetic Macular Edema

Aim of Study: To assess the improvement of best corrected visual acuity and its correlation with pre-operative variables and change in macular thickness following pars plana vitrectomy and ILM peeling for diffuse non-tractional diabetic Macular Edema. Methods: 25 eyes with persistent diabetic macular edema were treated with 23 guage transconjunctival PPV with ILM peeling. Pre-operative evaluation performed including full medical and ophthalmological history and examination. Central Subfield Macular Thickness (CSMT) and BCVA was evaluated at 6 weeks and 3 months and 6 months post-operatively. Results: Mean pre-operative BCVA (decimal notation) was 0.1 (SD±0.0674). Mean BCVA was 0.1182 (SD±0.09700), 0.1382 (SD±0.09881), 0.1598 (SD±0.10273) at 6 weeks, 3 months and 6 months post-operative respectively Figs. (27- 29). Mean post-operative change in BCVA from base line was 0.0149 (SD±0.08749), 0.0349 (SD±0.08808) and 0.0565 (SD ±0.09152) at 6 weeks, 3 months and 6 months post-operative respectively which was statistically significant at 6 months (p-value=0.008). There was no visual improvement in 8 eyes (32%) and 17 eyes experienced visual improvement (68%) but this was not statistically significant (p-value=l). All non-improved cases were females and this was statistically significant by fisher s exact test (p-value=0.026). There was anatomical improvement (improvement of central foveal thickness) in 23 eyes (92%) and with no improvement in 2 eyes (8%). Visual and anatomical improvements were correlated in 16 eyes however, visual improvement without anatomical improvement occurred in one eye which wasn t statistically significant.Conclusion: There was a limited visual improvement which was statistically significant only at 6 months postoperatively and there was no statistically significant correlation between visual improvement and anatomical improvement.