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目的：探讨分析改良膜分割与双手膜清除技术，在23G玻璃体手术中治疗增殖性糖尿病视网膜病变（P DR）中的优缺点。方法将有玻璃体手术指征的P DR患者38例41眼纳入研究，进行前瞻性随机对照，采用随机数字表法将患者分为双手膜清除组、改良膜分割组，比较两种增殖膜去除理念———双手膜清除、改良膜分割的优缺点。比较术中医源孔数量、手术时间、术后视力改善、并发症发生情况等指标。结果改良膜分割技术降低了医源孔的发生，降低了硅油注入率，并未提高术后玻璃体积血、增殖膜及其他并发症的发生率，同时不影响视功能恢复。结论改良膜分割技术适用于23 G玻璃体手术治疗增殖性糖尿病视网膜病变，联合手术优势明显，疗效良好。“,”Objective To investigate the differences between improved membrane dissection and bimanual enbloc exci-sion in 23G vitrectomy in the treatment of proliferative diabetic retinopathy (P DR).Method A total of 38 P DR patients(41 eyes)undergoing vitrectomy from Jun 2013 to Jan 2014 was enrolled in this study.The patients were ran-domly divided into bimanual enbloc excision group(19 patients,20 eyes)and improved membrane dissection group(19 patients,21 eyes).After the procedures,number of iaogenic holes,ratio of silicon oil fill,operation time,postopera-tive hemorrhage,and postoperative proliferative membrane were observed.Result Improved membrane dissection decreased the number of iaogenic holes,ratio of silicon oil fill,without increasing the operation time,incidence of postop-erative hemorrhage,or proliferative membrane aggravation.Meanwhile,visual function recovery wasnt influnced. Conclusion The improved membrane dissection is better in 23G vitrectomy to treat proliferative diabetic retinopathy(P DR).