Effect of vitrectomy with internal limiting membrane peeling on the patients with proliferative diabetic retinopathy

This study evaluated the effect of internal limiting membrane (ILM) peeling during pars plana vitrectomy (PPV) in patients with proliferative diabetic retinopathy (PDR). A retrospective analysis was conducted on the medical records of 88 PDR patients, 88 eyes, who underwent PPV for vitreous hemorrhage and/or epiretinal membrane (ERM) and/or macular-involved tractional retinal detachment. Patients were divided into two groups: Group A (PPV with ILM peeling), and Group B (PPV without ILM peeling), with a minimum 12-month follow-up. Outcomes were analyzed using multivariate logistic regression. All models were adjusted for age, gender (basic demographic confounders), and preoperative PRP in the multivariate analyses. Both groups showed significant BCVA improvement, with the peeling group demonstrating better final visual acuity ( p < 0.001). The peeling group also had lower incidences of anti-VEGF therapy ( p < 0.05), secondary ERM ( p < 0.001), and repeat PPV ( p = 0.007), with no significant difference in other complications. Multivariate analysis confirmed ILM peeling was strongly associated with improved visual acuity (OR = 6.90 [2.20–21.69], p < 0.001), reduced secondary ERM (OR = 0.05 [0.01–0.24], p < 0.001), and fewer reoperations (OR = 0.06 [0.01–0.54], p = 0.013). In conclusion, while both procedures improved BCVA, PPV with ILM peeling provided superior outcomes, suggesting potential benefits of ILM peeling for PDR patients undergoing vitrectomy.