L. O. Hattenbach, P. N. Jentzmik, J. Puchta, Y. Sinangin, F. Koch – Klinik für Augenheilkunde, Netzhaut- und Glaskörperchirurgie, Klinikum der Johann Wolfgang Goethe Universität, Frankfurt am Main, Germany


To investigate visual recovery and clinical outcome after pars plana vitrectomy with or without internal limiting membrane (ILM) peeling in patients with macular edema associated with proliferative diabetic vitreoretinopathy (PDVR).


Fourty-nine eyes of 40 patients with PDVR, diabetic macular edema and severe visual loss were included in this study. All patients underwent a 20 ga or 25 ga three-port-pars plana vitrectomy with or without indocyanine green assisted ILM peeling. We documented intraoperative and postoperative course, complications and visual outcome. Minimum follow-up time was 4 months.


By the end of the follow-up period, visual acuity was improved 2 or more lines in 18 of 49 eyes (36.7%). In 22 of 49 eyes (44.9%), final visual acuity remained unchanged (2 lines). A further decrease in visual acuity was observed in 9 eyes (18.4%). There was a tendency for those eyes that underwent ILM peeling to have better final visual recovery, although this difference did not reach statistical significance. Postoperatively, severe vitreous hemorrhage occurred in 3 of 49 eyes. Repeat vitrectomy was performed in 2 cases.


Our findings suggest that vitrectomy has the potential to improve visual recovery in PDVR patients with macular edema. Combined ILM peeling may have a beneficial effect, although the true value of this surgical technique remains to be investigated.

Take-home message:

Vitrectomy is of value for an improved visual recovery in PDVR patients with macular edema. Combined ILM peeling may be beneficial in selected cases.