AIM: To observe the clinical effect of vitrectomy(PPV)combined with internal limiting membrane(ILM)peeling in the treatment of refractory diabetic macular edema.

METHODS: The data of 56 eyes(56 patients)with refractory diabetic macular edema accepted PPV combined with ILM peeling were collected and retrospectively analyzed. The patients were divided into Group A(no posterior vitreous detachment): 35 cases(35 eyes)and Group B(with posterior vitreous detachment): 21 cases(21 eyes). The best corrected visual acuity(BCVA)and central macular thickness(CMT)before and 1, 3, 6mo after operation were compared and analyzed.

RESULTS: The mean CMT and LogMAR BCVA of Group A at 1, 3 and 6mo after operation were significantly different from those before operation(P<0.05); There was no significant difference in BCVA between those before and 1, 3, 6mo after operation in Group B(P>0.05). The mean CMT of 1mo after operation was significantly different from that before operation(P<0.05). There was no significant difference in mean CMT between 3 and 6mo after operation and before operation(P>0.05). CMT and BCVA were significantly different between the two groups at 1,3 and 6mo postoperatively(P<0.05).

CONCLUSION: PPV combined with ILM peeling can effectively treat refractory diabetic macular edema without posterior vitreous detachment, improve the patient's vision; However, PPV combined with ILM peeling was not effective in patients without posterior vitreous detachment.