The role of internal limiting membrane peeling in the surgical treatment of diabetic macular edema (clinical observations

Vitreoretinal surgery (VRS) is the treatment of choice when diabetic macular edema (DME) is combined with other vitreomacular interface (VMI) anomality. Many studies give contradictory results and the question of the need to perform peeling of the internal limiting membrain (ILM) remains open. Purpose. To demonstrate the results of surgical treatment with and without ILM peeling in patients with DME combined with epimacular fibrosis. Material and methods. The article presents a comparative analysis of three clinical cases. The patients had similar clinical and anamnestic characteristics. In three cases, patients underwent VRS for DME in combination with epimacular fibrosis (EMF). In two cases, the ILM peeling stage was performed, in the third case, the ILM remained intact. Results. According to the results of observation and assessment of anatomical and functional parameters, complications in the long-term postoperative period were revealed in the case of the 1st and 2nd patients, and in the case of the 3rd patient — stabilization of the process. Conclusion. The presented clinical cases demonstrate that anatomical and functional results do not always correlate with each other. The high risk of complications with a violation of the architectonics and functions of the retina during the ILM peeling raises the question of the expediency of its implementation.