The role of ILM peeling in vitreous surgery for proliferative diabetic retinopathy complications.

Background And Objective: To evaluate the influence of pars plana vitrectomy (PPV) with or without internal limiting membrane (ILM) peeling on spectral-domain optical coherence tomography (SD-OCT) in vitreous hemorrhage and tractional retinal detachment as a complication of diabetic retinopathy.

Patients And Methods: Retrospective study of PPV in patients with diabetic retinopathy complications. Group A (53 patients) had PPV with ILM peeling, and group B (59 patients) had PPV without ILM peeling. SD-OCT imaging and fluorescein angiography were performed postoperatively.

Results: Preoperative visual acuity was 0.04 and final postoperative visual acuity was 0.27 in both groups (23.4 months in group A, 60 months in group B). Postoperative central retinal thickness was 193 μm (group A) and 258.6 μm (group B). Epiretinal membranes were observed less frequently in group A than in group B (24% vs 49%). Repeated surgeries were performed in 38 cases in group A and in 51 cases in group B.

Conclusion: Fewer cases of epiretinal membranes and macular edema are observed postoperatively with ILM peeling. Visual acuity is similar in both groups, but additional surgeries are fewer with ILM peeling.