title: Pars plana vitrectomy for diabetic fibrovascular proliferation with and without internal limiting membrane peeling.
abstract: 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.
authors.affiliation: Department of Ophthalmology, Far Eastern Memorial Hospital, Pan-Chiao, Taipei, Taiwan.
authors.forename: P-Y
authors.initials: PY
authors.lastname: Chang
authors.forename: C-M
authors.initials: CM
authors.lastname: Yang
authors.forename: C-H
authors.initials: CH
authors.lastname: Yang
authors.forename: M-S
authors.initials: MS
authors.lastname: Chen
authors.forename: J-Y
authors.initials: JY
authors.lastname: Wang
mesh_terms: D000368:Aged; D001485:Basement Membrane / Q000473:pathology; D003930:Diabetic Retinopathy / Q000150:complications* / Q000473:pathology / Q000601:surgery; D005260:Female; D005584:Fovea Centralis / Q000473:pathology; D006801:Humans; D008266:Macula Lutea / Q000473:pathology; D008297:Male; D008875:Middle Aged; D041623:Tomography, Optical Coherence; D014792:Visual Acuity; D014821:Vitrectomy / Q000379:methods*; D018630:Vitreoretinopathy, Proliferative / Q000150:complications / Q000473:pathology / Q000601:surgery*