Objective To evaluate the anatomical and functional results of internal limiting membrane (ILM) peeling during pars plana vitrectomy for fibrovascular proliferation (FVP) in diabetic retinopathy.
Methods The study was a prospective comparative case series in design. Patients undergoing pars plana vitrectomy for mild to moderate diabetic FVP were divided into either Group 1: vitrectomy only, or Group 2: further ILM peeling in the macular area. Best-corrected visual acuity, fundus examination, and optical coherence tomography (OCT) were conducted at 3 and 6 months postoperatively.
Results There were 26 eyes of 25 patients in Group 1 (non-ILM peeling) and 23 eyes of 22 patients in Group 2 (ILM peeling). At 6 months postoperatively, OCT-identifiable epiretinal membrane (ERM) was found in 10 of 26 eyes (38.5%) in Group 1and 0 of 23 eyes in Group 2 (P=0.001) and six eyes (23.1%) in Group 1 developed biomicroscopic ERM, whereas no patients in Group 2 had ERM (P=0.02) at 6 months. OCT identifiable ERM correlated significantly with central macular thickness (r=−0.58, P<0.001), the presence of intraretinal cystic space (r=0.60, P<0.001), and fovea depression reappearance (r=0.36, P=0.008). Factors associated with poor visual outcome were macular detachment (P<0.001) and non-ILM peeling (P=0.004).
Conclusions This pilot study suggests that ILM peeling during vitrectomy for diabetic fibrovascular proliferative membranes may minimize postoperative ERM formation and improve visual prognosis. diabetic retinopathy;internal membrane peeling;epiretinal membrane;fibrovascular proliferation
