Pars plana vitrectomy with and without internal limiting membrane peeling for diabetic patients with macula involved tractional retinal detachment

Abstract

Purpose: To evaluate the effect of internal limiting membrane (ILM) peeling on anatomical and functional results in pars plana vitrectomy performed eyes with tractional retinal detachment affecting the macula because of diabetes mellitus. Methods: Patients without ILM peeling were considered as Group 1, and patients with ILM peeling were considered as Group 2. The main outcomes were the best-corrected visual acuity at 6 months and the rate of epiretinal membrane formation within 6 months. The rate and the indications for resurgery were determined. Parameters affecting the final best-corrected visual acuity were determined by regression analysis. Results: Final best-corrected visual acuity was significantly better in eyes with ILM peeled off than in eyes with no peel-off (P = 0.012). Less secondary epiretinal membrane was formed in Group 1 (P = 0.009). There was no difference between groups in resurgery rates (P = 0.143). The need for resurgery because of epiretinal membrane was higher in Group 1 rather than Group 2 (P = 0.001). The only factor affecting the final best-corrected visual acuity was ILM peeling. Conclusion: In patients with tractional retinal detachment affecting the macula because of diabetes, ILM peeling in addition to pars plana vitrectomy and membrane excision does not affect the need for resurgery but contributes positively to anatomical and functional outcomes.