{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T23:28:42Z","timestamp":1790378922530,"version":"4.1.0"},"reference-count":54,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,5,24]],"date-time":"2025-05-24T00:00:00Z","timestamp":1748044800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: The aim of this study was to evaluate the outcome of pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peeling in patients with diabetic macular edema (DME) refractory to intravitreal injections (IVIs) and without vitreomacular traction. Methods: In this retrospective consecutive case series, we included patients that underwent PPV with ILM peeling for refractory DME. Examination was performed at baseline, and at the 1- and 6-month follow-up. Primary endpoints were best-corrected distance visual acuity (BCVA) and central macular thickness (CMT). Results: A total of 15 eyes were included, and BCVA improved from 0.69 \u00b1 0.27 logMAR preoperatively to 0.48 \u00b1 0.28 logMAR at the 1-month (p = 0.013) follow-up and 0.42 \u00b1 0.29 logMAR at the 6-month (p &lt; 0.001) follow-up. At the 6-month follow-up, 10 eyes (66.6%) gained at least two lines of vision. The BCVA of pseudophakic eyes (nine eyes) improved from 0.64 \u00b1 0.21 logMAR at baseline to 0.40 \u00b1 0.26 logMAR at the 6-month follow-up (p = 0.02). CMT decreased from 457 \u00b1 114 \u00b5m preoperatively to 336 \u00b1 112 \u00b5m at the 1-month (p = 0.035) follow-up and 302 \u00b1 68 \u00b5m at the 6-month (p = 0.001) follow-up. During follow-up, only two eyes received IVIs: one following vitreous hemorrhage and one for persistent DME. Conclusion: PPV with ILM peeling improves BCVA and reduces CMT in eyes with DME refractory to IVIs up to the 6-month follow-up.<\/jats:p>","DOI":"10.3390\/jcm14113686","type":"journal-article","created":{"date-parts":[[2025,5,25]],"date-time":"2025-05-25T20:26:50Z","timestamp":1748204810000},"page":"3686","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Pars Plana Vitrectomy and ILM Peeling for Refractory Diabetic Macular Edema Without Vitreomacular Traction"],"prefix":"10.3390","volume":"14","author":[{"given":"Sylvain","family":"el-Khoury","sequence":"first","affiliation":[{"name":"SOS R\u00e9tine Sud, 29 Boulevard de la Ferrage, 06400 Cannes, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chloe","family":"Ngo","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University Hospital Rouen, 37 Boulevard Gambetta, 76000 Rouen, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Muraine","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University Hospital Rouen, 37 Boulevard Gambetta, 76000 Rouen, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Youssef","family":"Abdelmassih","sequence":"additional","affiliation":[{"name":"Department of Retina and Pediatric Ophthalmology, Rothschild Foundation Hospital, 29 rue Manin, 75019 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandre","family":"Portmann","sequence":"additional","affiliation":[{"name":"SOS R\u00e9tine Sud, 29 Boulevard de la Ferrage, 06400 Cannes, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2653","DOI":"10.2337\/diacare.26.9.2653","article-title":"Diabetic Retinopathy and Diabetic Macular Edema: Pathophysiology, Screening, and Novel Therapies","volume":"26","author":"Ciulla","year":"2003","journal-title":"Diabetes Care"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1334","DOI":"10.1001\/jamaophthalmol.2014.2854","article-title":"Prevalence of and Risk Factors for Diabetic Macular Edema in the United States","volume":"132","author":"Varma","year":"2014","journal-title":"JAMA Ophthalmol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1159\/000455265","article-title":"Mechanisms of Retinal Fluid Accumulation and Blood-Retinal Barrier Breakdown","volume":"58","year":"2017","journal-title":"Dev Ophthalmol"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/S0002-9394(02)01837-8","article-title":"Optical Coherence Tomography for Evaluating Diabetic Macular Edema before and after Vitrectomy","volume":"135","author":"Massin","year":"2003","journal-title":"Am. 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