title: EFFECT OF INTERNAL LIMITING MEMBRANE PEELING DURING VITRECTOMY FOR DIABETIC MACULAR EDEMA: Systematic Review and Meta-analysis.
abstract: OBJECTIVE
  To evaluate the effect of internal limiting membrane (ILM) peeling during vitrectomy for diabetic macular edema.
  
  
  METHODS
  MEDLINE, EMBASE, and CENTRAL were systematically reviewed. Eligible studies included randomized or nonrandomized studies that compared surgical outcomes of vitrectomy with or without ILM peeling for diabetic macular edema. The primary and secondary outcome measures were postoperative best-corrected visual acuity and central macular thickness. Meta-analysis on mean differences between vitrectomy with and without ILM peeling was performed using inverse variance method in random effects.
  
  
  RESULTS
  Five studies (7 articles) with 741 patients were eligible for analysis. Superiority (95% confidence interval) in postoperative best-corrected visual acuity in ILM peeling group compared with nonpeeling group was 0.04 (-0.05 to 0.13) logMAR (equivalent to 2.0 ETDRS letters, P = 0.37), and superiority in best-corrected visual acuity change in ILM peeling group was 0.04 (-0.02 to 0.09) logMAR (equivalent to 2.0 ETDRS letters, P = 0.16). There was no significant difference in postoperative central macular thickness and central macular thickness reduction between the two groups.
  
  
  CONCLUSIONS
  The visual acuity outcomes using pars plana vitrectomy with ILM peeling versus no ILM peeling were not significantly different. A larger randomized prospective study would be necessary to adequately address the effectiveness of ILM peeling on visual acuity outcomes.
authors.affiliation: Department of Ophthalmology, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Takuya
authors.initials: T
authors.lastname: Nakajima
authors.forename: Murilo F
authors.initials: MF
authors.lastname: Roggia
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Noda
authors.forename: Takashi
authors.initials: T
authors.lastname: Ueta
mesh_terms: D001485:Basement Membrane / Q000601:surgery; D016208:Databases, Factual; D003930:Diabetic Retinopathy / Q000503:physiopathology / Q000601:surgery*; D019773:Epiretinal Membrane / Q000601:surgery*; D006801:Humans; D008269:Macular Edema / Q000503:physiopathology / Q000601:surgery*; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy