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Improved staining, dyes assist ILM peeling
 Stanley Chang |
ORLANDO, Fla. — For macular holes, it may be safer to peel a small zone of internal limiting membrane around the hole rather than peel extensively, a speaker told colleagues here.
The 2011 Schepens Lecturer Stanley Chang, MD, shared his experience with internal limiting membrane (ILM) peeling for macular pucker at the Retina Subspecialty Day preceding the American Academy of Ophthalmology meeting. He said that arguments for ILM peeling include the fact that the retinal striae are more likely to resolve and there is a low recurrence rate. Also, improved staining and dyes, such as triamcinolone, indocyanine green, trypan blue and brilliant blue, assist in ILM peeling. Brilliant blue dye, used off label for this procedure, may be helpful by demonstrating areas of residual cortical vitreous on the ILM, Dr. Chang said.
"In recent years, ILM peeling has become more popular," he said, adding that there are arguments against the procedure as well, "mainly that vision outcomes are good but there is no difference in eyes that have had ILM peeling."
Late functional effects of ILM peeling should be evaluated, he said, because he has seen cases post-ILM peeling where there are late retinal changes.
- Disclosure: Dr. Chang is a consultant for OMIC Ophthalmic Mutual Insurance Company and has financial interests in Alcon and Alimera Sciences.