OBJECTIVE: This study aimed to explore liver and kidney function as well as bone metabolism in patients undergoing diabetic retinal surgery, and to evaluate their clinical significance in predicting postoperative outcomes. METHODS: A total of 150 patients (172 eyes) with proliferative diabetic retinopathy (PDR) who underwent retinal surgery were retrospectively analyzed and categorized into a vitrectomy group (n=78) and a photocoagulation group (n=72). Additionally, 50 healthy adults were included as the control group. Hepatic and renal function parameters, along with bone metabolism markers, were assessed before and after surgery. Logistic regression analysis was employed to evaluate their association with postoperative prognosis, while receiver operating characteristic (ROC) curves were used to assess the predictive performance of key indicators. RESULTS: Compared to the control group, patients with PDR showed significantly elevated levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin (TBIL), urinary albumin-to-creatinine ratio (UACR), serum creatinine (Scr), and serum cystatin C (sCys-C), along with markedly reduced levels of glomerular filtration rate (GFR) and osteocalcin (all P <
0.05). When comparing treatment groups, the vitrectomy group exhibited a significantly higher overall improvement rate than the photocoagulation group (80.00% vs. 37.80%). Moreover, patients in the vitrectomy group demonstrated lower levels of AST, ALT, TBIL, UACR, Scr and sCys-C, and higher levels of GFR and osteocalcin (all CONCLUSION: In diabetic patients undergoing retinal surgery, hepatic and renal function, along with bone metabolism, are significantly altered and appear to improve following surgical intervention. Specifically, levels of AST, ALT, TBIL, and GFR are closely associated with postoperative prognosis and may serve as valuable predictors of clinical outcomes.