A Comparative Study of Vitrectomy with and Without Internal Limiting Membrane Peeling In Diabetic Macular Holes

Context: To clarify if Internal Limiting Membrane (ILM) peeling during Para Plana Vitrectomy (PPV) for diabetic macular hole can improve the visual and anatomical outcome of Diabetic Macular Holes (DMH). Design: Prospective case-control study. Participants: 60 eyes of 60 diabetic patients with DMH. Methods: 30 eyes underwent PPV with ILM peeling (group 1), while PPV only was performed in the other 30 eyes (group 2) with DMH. Closure of the macular hole and visual acuity were assessed and compared at the end of the six postoperative months. Results: Anatomical closure was achieved in 15 of group 1 eyes, while it was statistically significant higher in group 2 eyes (24 eyes). Eyes which underwent ILM peeling achieved statistically significant more visual gain than eyes with no ILM peeling with 18 and 10 eyes improved two or more Senellen lines in group 2 and group 1, respectively. Conclusion: visual outcome and anatomical closure of diabetic macular holes were significantly higher in eyes where ILM peeling was performed compared to the other group. Accordingly, bimanual dissection of ILM during PPV may be mandatory to achieve better visual prognosis and anatomical outcome in eyes with diabetic macular holes.