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ILM peeling may enable complete removal of epiretinal membrane, prevent macular pucker
Retina. 2012;32(2):226-231.
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Complete removal of epiretinal membrane and prevention of macular pucker may be achieved through primary peeling of the internal limiting membrane, a study found.
"We proved that ILM peeling causes inhibition of the process of visible fibrosis. In all cases, after retinectomy with ILM peeling, we did not find macular pucker and [epiretinal membranes] were formed only by the margin of retinotomy in the place where ILM was not removed," the study authors wrote.
The nonrandomized, prospective review included 84 eyes of 84 patients who underwent retinectomy for retinal detachment because of proliferative vitreoretinopathy. Internal limiting membrane (ILM) peeling was performed in 33 eyes, while the ILM was left intact in the remaining 51 eyes.
Median follow-up was 28.2 months for the group that underwent ILM peeling and 27.4 months for the group that did not.
Mean logMAR visual acuity at final follow-up was 1.89 ± 0.87 in the ILM group and 1.85 ? 0.83 in the group without peeling.
Extramacular epiretinal cellular proliferation occurred in 9% and 5.8%, respectively, of eyes in the two groups, and these membranes remained stable during follow-up. Macular pucker was not observed in any of the ILM eyes, but 17.6% of eyes without peeling did experience this complication (P = .008).