[Proliferative diabetic retinopathy: fewer complications with early surgery].

Legal blindness due to proliferative diabetic retinopathy (PDR) in patients with diabetes mellitus can be preventable if detected and treated in a timely manner. Although vitrectomy has traditionally been reserved for complicated cases, advances in surgical techniques and a better understanding of pathophysiology have driven its evaluation as an early or preventive strategy in selected patients. This article presents a systematic review in PubMed (2020-2025), with an emphasis on classic studies, on the safety and efficacy of vitrectomy as an early intervention in patients with PDR, before the onset of major complications, using the keywords "diabetic vitrectomy," "proliferative diabetic retinopathy," "retinal diseases," and "vitreous hemorrhage". Most of the specific evidence in Mexican or Latin American populations is limited, which is why general evidence used as a reference in the region was also included. Studies published in English and in open-access were included. The reviewed studies consistently report that early vitrectomy helps maintain or improve visual acuity during follow-up, reduces progression to severe complications, and shows low rates of intraoperative adverse events. It is concluded that early vitrectomy in selected patients with PDR represents a safe and effective strategy with the potential to preserve vision and alter the natural history of the disease. However, prospective multicenter clinical trials are needed to establish standardized selection criteria and validate its long-term impact.