OBJECTIVE: 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; χ 2 = 0.296, P = 0.587).
CONCLUSIONS: PPV with ILM peeling can significantly improve the visual acuity of patients with DME, reduce CMT, and improve CME with fewer complications.
目的:观察PPV联合ILM剥离对术后中央黄斑厚度(CMT)的影响,最佳矫正视力(BCVA),黄斑囊样水肿(CME)体积,DME患者的并发症。
方法:2022年1月至12月在北京山曲良乡医院诊断为DME的81例(92只眼)随机分为单纯PPV(对照组41例,47只眼)或PPV+ILM剥离(剥离组:40例,45眼);一名外科医生进行了所有手术。比较两组术前及术后1、3个月。
结果:术前,两组的CMT值具有可比性,BCVA,和CME体积(P>0.05)。手术后(1个月和3个月),两组均显示CMT显着降低,BCVA,和CME体积与术前水平相比,剥离组较对照组降低更显著(P<0.05)。对组内差异的进一步重复测量ANOVA分析揭示了组和时间的显着影响,和CMT的相互作用效应,BCVA,和CME体积(P<0.05)。两组并发症发生率差异无统计学意义(视网膜脱离:对照=2,剥离=1;眼内炎:对照=4,剥离=1;无继发性青光眼或黄斑裂孔病例;χ2=0.296,P=0.587)。
结论:PPV联合ILM剥离可显著提高DME患者的视力,减少CMT,并以更少的并发症改善CME。