This article focuses on the surgical treatment of the vitreomacular traction ( VMT) syndrome comparing vitrectomy with and without internal limiting membrane (ILM) removal. Patients were randomly divided into 2 groups. In the 1st group, the procedure was performed without the ILM removal. In the 2nd group, the surgery was performed with perifoveolar ILM removal. A comparative analysis revealed that an anatomical result was reached in both groups, but in the 1st group, the development of epiretinal fibrosis was observed in 35 % of the cases in the late postoperative period; and this was not observed in the 2nd group. Visual function recovery was faster in the 1st group, but at 1 year visit, data from both groups were comparable. Thus, the treatment method with surgical ILM removal is preferable, due to more stable anatomical result.