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ILM peeling with vitrectomy may reduce premacular fibrosis recurrence, study says
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In the long term, internal limiting membrane peeling with vitrectomy can reduce reformation rates of premacular fibrosis and may not be as harmful as previously understood, a retrospective study suggests.
"Surgical removal of [premacular fibrosis] with ILM peeling was not associated with unfavorable outcomes in our group of patients," the study authors said.
Ramin Schadlu, MD, and colleagues evaluated visual outcomes for 38 patients who underwent pars plana vitrectomy and triamcinolone-assisted ILM peeling. In addition, the investigators examined the incidence of postoperative complications, including cataract formation, endophthalmitis, retinal detachment, vitreous hemorrhage, retinal or subretinal hemorrhage, macular hole formation, cystoid macular edema and premacular formation recurrence.
In these eyes, pretreatment visual acuity averaged 20/90. Follow-up averaged 20.2 months.
At final follow-up, vision had improved or remained stable in 89.5% of eyes, and visual acuity had improved by an average of 2.2 lines in all patients, the authors noted.
The most common complication was cataract formation; subsequently, two patients developed cystoid macular edema within 4 weeks after cataract surgery.
Biomicroscopic recurrence of premacular fibrosis occurred in only one patient (2.6%).
"No adverse outcomes were noted in patients with higher levels of visual acuity and these were in fact the patients with best final visual acuity," the authors said.
The study is published in the June edition of Retina.