目的：探讨玻璃体切割术(PPV)联合或不联合内界膜(ILM)剥除术治疗顽固性糖尿病黄斑水肿的疗效。

方法：回顾性选取80例80眼顽固性糖尿病黄斑水肿患者，根据治疗方法进行分组，其中采用PPV治疗的38例38眼患者为A组，采用PPV联合ILM剥除术治疗的42例42眼患者为B组，收集两组患者相关资料，比较两组疗效。

结果：术后1、3、6 mo，B组最佳矫正视力(BCVA)、黄斑中心区视网膜厚度(CMT)以及黄斑水肿严重程度均优于A组(均P<0.05)。术后6 mo，B组并发症发生率为12%，较A组的18%无明显差异(P>0.05)。

结论：PPV联合或不联合ILM剥除术治疗顽固性糖尿病黄斑水肿均能改善患者视功能，缓解黄斑水肿情况，但两者联合应用在视力改善和缓解水肿方面优于单纯PPV，且术后未增加并发症的发生。

METHODS:Totally 80 patients with refractory diabetic macular edema were retrospectively selected and assigned into groups according to the treatment method. Among them, 38 patients treated with PPV were included as group A, and 42 patients treated with PPV combined with ILM peeling were included as group B. The relevant data of patients in the two groups were collected, and the efficacy of the two groups was compared.

RESULTS: At 1, 3, and 6 mo after surgery, the best corrected visual acuity(BCVA), central macular thickness(CMT), and severity of macular edema in the group B were all superior to those in the group A(all P<0.05). At 6 mo after the surgery, the incidence of complications in the group B was 12%, with no prominent difference compared to 18% of the group A(P>0.05).

CONCLUSION:PPV combined with or without ILM peeling can improve visual function and relieve macular edema in patients with refractory diabetic macular edema. However, the combination of PPV and ILM peeling is superior to PPV alone in improving vision and relieving macular edema, and does not increase postoperative complications.