Internal Limiting Membrane Peeling in Vitreous Surgery for Diabetic Macular Edema

228

Jpn J Ophthalmol Vol 47: 226–231, 2003

characteristics shown by ophthalmoscopic, fluorescein angiographic (FA), and IA findings. Results: Abnormal choroidal staining during IA was observed in 90% of the affected eyes and 67% of the fellow eyes. The average abnormal staining area was larger in the affected eyes than in the fellow eyes and decreased over time in both affected and fellow eyes, but the decrease rate of the abnormal staining was higher in the affected eyes. In FA abnormal staining areas of the smokestack type were significantly smaller than those of the round-diffusion type. The range of abnormal choroidal staining was significantly smaller in the affected eyes treated with laser photocoagulation than in the eyes not treated with laser coagulation. Conclusion: We conclude that the range of abnormal choroidal staining is consistent with changes of activity in the course of CSC, that the malfunction of the retinal pigment epithelium and choroidal hyperpermeability mutually influence CSC and that the disappearance of serous detachment in the clinical course plays an important role in the improvement of choroidal permeability and retinal pigment epithelium function. (J Jpn Ophthalmol Soc 106:583–589, 2002) Junichi Ochiai, Mayumi Kato, Hiroshi Tanikawa and Yoshiharu Kobayashi

for absorption of macular edema, and the postoperative visual acuity. Results: The absorption rate of macular edema was more than 90% with or without the ILM peeling. The period required for absorption of macular edema in eyes with ILM peeling was shorter in type II. There was no difference in postoperative visual acuity with or without ILM peeling. ILM peeling was not an important factor for postoperative visual acuity. Conclusion: ILM peeling accelerates the absorption of edema in more severe diabetic macular edema cases, but we could not find any improvement in visual acuity. (J Jpn Ophthalmol Soc 106:590–594, 2002) Kazuyuki Kumaga*, Nobuchika Ogina*, Mariko Furukawa†, Seiji Demizu*, Kazunari Atsumi†, Hideyuki Kurihara‡, Masayoshi Iwaki§, Hitoshi Ishigooka¶ and Naoko Tachi¶ *Shinjo Ophthalmologic Institute; †Department of Ophthalmology, Kami-iida First General Hospital; ‡ Kurihara Eye Hospital; §Department of Ophthalomology, Aichi Medical University; ¶Department of Ophthalmology, Kyoto Katsura Hospital; ¶Department of Ophthalmology, Shinseikai Toyama Hospital PII S0021-5155(02)00710-4

Department of Ophthalmology, Teikyo University School of Medicine PII S0021-5155(02)00709-8

Internal Limiting Membrane Peeling in Vitreous Surgery for Diabetic Macular Edema Purpose: To evaluate the effect of internal limiting membrane (ILM) peeling in vitreous surgery for diabetic macular edema. Methods: This study was done on 135 eyes of 103 patients who all underwent diabetic macular edema surgery under the same surgeon. The subjects were 55 males (74 eyes) and 48 females (61 eyes), aged 35–81 years, with an average of 62 years. The postoperative follow-up period ranged from 12 to 39 months, with an average of 20 months. The ILM peeling was performed in 74 eyes. The subjects were divided into two types of macular edema based on the presence (type II, 81 eyes) or absence (type I, 54 eyes) of hard exudates in the macular region. We evaluated the effects of the ILM peeling on the absorption rate of macular edema, the period required

Surgical Removal of Subfoveal Hard Exudates in Diabetic Maculopathy Purpose: To examine the efficacy of surgical removal of subfoveal hard exudates during surgery in diabetic maculopathy. Patients and Methods: This study was done on 60 patients (66 eyes) who all underwent surgical removal of subfoveal hard exudates under the same surgeon. Thirty-two men (37 eyes) and 28 women (29 eyes) were included in this study. The average age of the patients was 60 years (range, 30–77 years). The average followup period was 21 months (range, 12–48 months). All eyes were classified into 3 groups: 13 postoperative massive type eyes, 31 massive type eyes, and 22 scatter type eyes. We evaluated the visual results by type. Results: Preoperative and postoperative mean visual acuity was as follows; postoperative massive type, 0.11, 0.22; massive type, 0.12, 0.29; and scatter type, 0.19, 0.33. Postoperatively, visual acuity improved significantly in all types. There were no subfoveal hard exudates postoperatively in any eyes. Conclusion: Surgical removal of massive subfoveal hard exudates is effective, but its effects on vision