A Clinical Study on Effects of Peeling of Retinal Internal Limiting Membrane with Triamcinolone Acetonide(TA) on Diabetic Macular Edema

s Objective :To evaluate the effects of peeling of retinal internal limiting membrane with TA in diabetic macular edema by observing changes of visual acuity,thickness of central fovea of macula,and intraocular pressure.Methods:We selected 60 eyes with diabetic macular edema.They were divided into two groups:study group(30 eyes)and control group(30 eyes).In the study group,30 eyes underwent pars plana vitrectomy with TA marker,in the end of operation,4mg TA were injected into the vitreous cavity.The control group,all eyes received simple pars plana vitrectomy.We compared the preoperative and postoperative(4 months)visual acuity of two groups,and observed difference between two groups.We also observed intraocular pressure of preoperative,postoperative on 14 days and 4 months,and difference between the two groups.Results:1.Visual acuity:In the study group,postoperative(4months)were significantly higher than preoperative(p0.01);And in the control group,postoperative visual acuity were significantly higher than preoperative(p0.05);In the study group,there were 25 eyes(84.6%)got visual acuity improved;while in the control group,there were 17 eyes(56.%)improved.There were significant difference between the two groups(p0.05).2.The thickness of central fovea of macular(OCT):In the study group,the thickness of central fovea of macular of 4 months after operation were less than preoperative(p0.01).The control group got the similar result.In the study group,there were 28 eyes got macular edema subsided(92.3%).While in the control group,there were 20 eyes got macular edema subsided(66.7%).There was significant difference between the two groups(p0.05).3.Intraocular pressure:In the study group,the intraocular pressure on 14 days after operation were higher than preoperative(p0.05);While there was no difference between 4 months later and preoperative(p0.05).In the control group,the intraocular pressure on 14 days after operation were higher than preoperative(p0.05),while there was no difference between 4 months later and preoperative(p0.05).In the study group,on 14 days after operation there were 8 eyes got their intraocular pressure over 21 mmHg,and in the control group,there were 7 eyes over 21mmHg.There was no difference between the two groups(p0.05).Conclusion:Simple pars plana vitrectomy was effective for diabetic macular edema;peeling of internal limiting membrane can improve the effect of operation.TA' marker assisted with vitrectomy and peeling of ILM can make the surgery more safe and exactly.