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BACKGROUND We evaluated the effect of adjunctive anti-vascular endothelial growth factor (anti-VEGF) therapy on postoperative visual recovery and intraocular pressure in patients undergoing pars plana vitrectomy (PPV) for intravitreal hemorrhage as a complication of proliferative diabetic retinopathy. MATERIAL AND METHODS This retrospective observational cohort study included 149 eyes with proliferative diabetic retinopathy that underwent PPV at a tertiary ophthalmology center. Patients were divided into 2 groups according to the use of adjunctive anti-VEGF therapy: 33 eyes received anti-VEGF treatment and 116 underwent PPV without anti-VEGF administration. Best-corrected visual acuity (BCVA, logMAR), and intraocular pressure were assessed preoperatively and at 1 and 6 months after surgery. Changes in BCVA over time were analyzed using a linear mixed-effects model with time, anti-VEGF treatment, and their interaction as fixed effects and patient as a random effect. Arterial hypertension was included as a covariate. RESULTS At 1 month after surgery, patients receiving anti-VEGF therapy demonstrated significantly better BCVA values compared with untreated patients (P<0.05). However, no significant differences in BCVA were observed between groups after 6 months (P>0.05). In the adjusted mixed-effects model, follow-up time was significantly associated with BCVA improvement, whereas anti-VEGF treatment was not independently associated with visual outcomes, and no significant interaction between treatment and time was identified. No significant differences in intraocular pressure were observed between groups either before or after surgery. CONCLUSIONS Adjunctive anti-VEGF therapy may accelerate early visual recovery after PPV without influencing long-term visual outcomes or intraocular pressure, supporting its safety as a perioperative adjunct in vitreoretinal surgery.