Pars Plana Vitrectomy for Treatment of Diabetic Macular Edema with or Without Internal Limiting Membrane Peeling: A Systematic Review and Meta-Analysis

Abstract

DME is defined as a retinal thickening in one DD of the centre of the macula. It is a number of microvascular retinal changes that lead to BRB disruption, causing leakage of fluid and plasma components into the inner and outer plexiform layers. DME is a major complication of DR and a main cause of loss of vision in diabetic patients. Many modalities of treatment have been developed to treat DME either nonsurgical or surgical procedures. Nonsurgical treatments for DME have included focal and grid macular laser photocoagulation (MLP), STTA, IVTA, and intravitreal injection of anti-vascular endothelial growth factor (anti-VEGF) agents. Surgical treatment considered vitrectomy when no response to nonsurgical treatments or in DME patients with epiretinal membrane or vitreomacular traction Several comparative studies exist comparing PPV alone with PPV with ILM peeling. However, the indications and benefits of ILM peeling remain controversial. This meta-analysis included 14 studies all were published between 2000 and 2019. They were RCTs – 753 eyes of participants with DME. The mean age ranged between 54.125 and 64.7 years. The baseline of the mean BCVA ranged between 1.077 and 0.6 log. MAR.