Efficacy of Internal Limiting Membrane Peeling in Eyes with Proliferative Diabetic Retinopathy: A Meta-Analysis.

Introduction: We investigated the effects of internal limiting membrane (ILM) peeling on treating posterior segment complications other than macular edema in patients with proliferative diabetic retinopathy (PDR) treated with vitrectomy.

Methods: Databases including PubMed, EMBASE, and Cochrane Library were searched on October 2, 2023. Studies comparing patients with PDR who were treated with ILM peeling to those who did not undergo ILM peeling were included. The primary outcome was the final best-corrected visual acuity (BCVA). Secondary outcomes were final central retinal thickness (CRT) and formation of the postoperative epiretinal membrane (ERM).

Results: Eleven comparative studies were included in this meta-analysis. The postoperative BCVA at 6 months was better in those who underwent ILM peeling (95% confidence interval [CI]: -0.51 to -0.15) than in those did not, whereas the final BCVA was not significantly different between the groups (95% CI: -0.30 to 0.00). The final CRT was significantly thin (95% CI: -61.82 to -35.63), with a low occurrence of postoperative ERM in the ILM peeling group (95% CI: 0.12-0.26).

Conclusion: ILM peeling effectively prevented postoperative ERM formation in patients with PDR complications; however, the benefit for postoperative vision was not evident after 6 months.