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Central retinal thickness (CRT) and best-corrected visual acuity (BCVA) were measured before surgery and at 1, 3, 6, and 12\u00a0months after surgery.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>A total of 722 patients with DME (482 in the VIT\u2009+\u2009CS group and 240 in the VIT group) were enrolled. CRT significantly decreased after 1\u00a0month and continued thereafter in both groups. BCVA significantly improved at 1\u00a0month in the VIT\u2009+\u2009CS group and at 6\u00a0months in the VIT group. In both groups, regardless of epiretinal membrane removal, CRT and BCVA significantly improved, with no additional benefit from concomitant internal limiting membrane peeling. The change in BCVA was significantly correlated with the change in CRT during 6\u00a0months postoperatively in all patients and in the VIT group. Patients with worse preoperative visual acuity had a higher likelihood of improved BCVA at 6 and 12\u00a0months after surgery. No significant difference in BCVA was observed before and after surgery in patients with a preoperative visual acuity of 20\/40 or better. However, in patients with a visual acuity of 20\/50 or worse, BCVA significantly improved 1\u00a0month after surgery.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Vitrectomy is anatomically and functionally effective for DME, and combined cataract surgery is beneficial in DME cases with cataracts. Patients with poor preoperative BCVA improved, while those with good vision maintained it. However, better preoperative vision increased the risk of postoperative deterioration, underscoring the need for careful evaluation of surgical indications.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Key messages<\/jats:title>\n            <jats:p>\n              <jats:bold>\n                <jats:italic>What is known<\/jats:italic>\n              <\/jats:bold>\n              <jats:list list-type=\"bullet\">\n                <jats:list-item>\n                  <jats:p>In vitrectomy for diabetic macular edema (DME), DRCR.net showed that 13\u201331% of patients experience decreased vision despite reduced edema, leaving the efficacy of vitrectomy uncertain.<\/jats:p>\n                <\/jats:list-item>\n              <\/jats:list>\n            <\/jats:p>\n            <jats:p>\n              <jats:bold>\n                <jats:italic>What is new<\/jats:italic>\n              <\/jats:bold>\n              <jats:list list-type=\"bullet\">\n                <jats:list-item>\n                  <jats:p>Our multicenter study demonstrated that vitrectomy with and without cataract surgery was effective in improving central retinal thickness and visual acuity in the patients with DME.<\/jats:p>\n                <\/jats:list-item>\n                <jats:list-item>\n                  <jats:p>Better preoperative visual acuity increased the risk of postoperative decline, and thus the need for careful evaluation of surgical indications.<\/jats:p>\n                <\/jats:list-item>\n              <\/jats:list>\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00417-025-06845-2","type":"journal-article","created":{"date-parts":[[2025,5,6]],"date-time":"2025-05-06T10:50:37Z","timestamp":1746528637000},"page":"2651-2662","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy of vitrectomy combined with and without cataract surgery for diabetic macular 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Participants were provided with information about the study, including its objectives and the use of their data and were given the opportunity to decline participation.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"All procedures involving human participants were in accordance with the ethical standards of the institutional and\/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.This article does not contain any studies with animals performed by any of the authors.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Human and animal rights"}},{"value":"All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers\u2019 bureaus; membership, employment, consultancies, stock ownership, or other equity interests; expert testimony or patent-licensing arrangements) or non-financial interest (such as personal or professional relationships, affiliations, knowledge, or beliefs) in the subject matter or materials discussed in this manuscript.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}