关键词: 内界膜剥除,  , 玻璃体切割术,  , 顽固性糖尿病性黄斑水肿,  , 微视野,  , 黄斑中心视网 , 膜厚度

Abstract:

Objective To observe the effect of pars plana vitrectomy（PPV）combined with or without in⁃ ner limiting membrane peeling in the treatment of refractory diabetic macular edema（DME）and its effect on visual function. Method We conducted a retrospective analysis of 40 patients with refractory DME diagnosed in our hos⁃ pital from May 2018 to May 2020 who received PPV combined with or without inner limiting membrane peeling， including 20 patients received PPV combined with inner limiting membrane peeling as the combination group，and 20 patients received PPV combined without inner limiting membrane peeling as the control group. The best correct⁃ ed visual acuity（BCVA），central macular thickness（CMT），retinal mean sensitivity（RMS），fixation stability and complications were compared between the two groups. Result In the last follow⁃up，BCVA of the two groups was significantly higher than that before operation（P < 0.05），and BCVA of the combination group was better than that of the control group（P < 0.05）. The CMT of the combined group and the control group decreased 1 month after the operation（P < 0.05）；at 1，3 and 6 month，the CMT in the combination group was thinner than that in the control group（P < 0.05）. The RMS of the combined group increased after surgery（P < 0.05），and the RMS of the contralateral eye in the combination group was better than that in the surgical eye 6 month after operation（P < 0.05）. After treatment，the fixation stability of the combined group was improved，but the difference was not statis⁃ tically significant（P > 0.05）. Conclusion In the treatment of refractory DME，PPV combined with inner limiting membrane peeling can effectively improve BCVA and reduce CMT and improve fixation stability to a certain extent.

Key words:

"> inner limiting membrane peeling, pars plana vitrectomy, refractory diabetic macular edema, microperimeter, central macular thickness