Impact of internal limiting membrane peeling on surgical outcomes in diabetic tractional retinal detachment

Abstract

Purpose

This study aimed to evaluate the anatomical and functional outcomes of internal limiting membrane (ILM) peeling during pars plana vitrectomy (PPV) in patients with tractional retinal detachment (TRD) secondary to proliferative diabetic retinopathy (PDR).

Methods

Patients who underwent PPV without ILM peeling were classified as Group 1, and those with ILM peeling as Group 2. Due to the retrospective design, sixth-month postoperative results were considered final outcomes. Main outcome measures included development of epiretinal membrane (ERM), best corrected visual acuity (BCVA), and reoperation rates.

Results

A total of 108 eyes of 108 patients were analyzed. At the final visit, ERM developed in 20.3% (13/64) of patients in Group 1 compared to 4.6% (2/44) in Group 2 (p = 0.02). Final BCVA was similar between groups (p = 0.603). Reoperation rates were 31.2% (20/64) in Group 1 and 20.4% (9/44) in Group 2 (p = 0.232). Reoperation due to ERM was necessary in 7 patients in Group 1, whereas no patients in Group 2 required surgery for ERM (p = 0.023).

Conclusion

ILM peeling during PPV in patients with TRD secondary to PDR significantly reduces ERM formation and improves anatomical outcomes. However, ILM peeling does not appear to affect the final visual acuity or overall reoperation rate.