Int Ophthalmol. 2026 Jan 21;46(1):65. doi: 10.1007/s10792-025-03924-5.
ABSTRACT
PURPOSE: To compare the functional and anatomical outcomes of pars plana vitrectomy (PPV) with or without internal limiting membrane (ILM) peeling in patients suffering with non-resolving vitreous hemorrhage and tractional retinal detachment.
METHODS: Fifty-seven patients (57 eyes) suffering from PDR were randomly assigned to undergo PPV with ILM peeling (n = 26) or without ILM peeling (n = 31). Outcomes assessed over a 6-month follow-up included best-corrected visual acuity (BCVA), need for additional anti-VEGF injections, frequency of reoperations, central macular thickness (CMT), development of epiretinal membrane (ERM), macular traction, and vascular parameters derived from OCT imaging.
RESULTS: Both groups showed statistically significant improvements in BCVA postoperatively (p < 0.001), with no significant difference between them (p = 0.846). The ILM peeling group required fewer repeat anti-VEGF injections (7.7% vs. 35.5%, p = 0.030) and exhibited a significantly lower incidence of secondary ERM (11.5% vs. 51.6%, p = 0.004). ERM formation correlated with iatrogenic retinal tears (p = 0.007) and tractional retinal detachment (TRD) (p < 0.001). Reoperations for ERM removal occurred exclusively in the non-ILM peeling group. No significant intergroup differences were found in CMT, foveal avascular zone (FAZ) area, or vessel density.
CONCLUSION: ILM peeling during diabetic vitrectomy effectively minimizes the risk of postoperative ERM formation and reduces the need for further Anti-VEGF injections for DME. However, it does not confer a significant advantage in terms of visual acuity improvements.
PMID:41563617 | DOI:10.1007/s10792-025-03924-5
