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ILM peeling may reduce retinal sensitivity, yield increase in microscotoma
Internal limiting membrane peeling may diminish retinal sensitivity and significantly increase the incidence of microscotoma, according to a study.
“Until a prospective trial confirming or not these results, it seems justified to avoid peeling the ILM when its potential benefit seems minor or unproved, and when peeling is carried out, to limit the surface peeled to the bare minimum,” the study authors said.
The retrospective study included 16 eyes of 16 patients who underwent closure of idiopathic macular hole. Eight eyes underwent ILM peeling. Clinical examination, fundus imaging, three-dimensional optical coherence tomography and combined spectral-domain OCT and scanning laser ophthalmoscopy microperimetry were performed 1 to 12 months after macular hole closure.
Study results showed that mean retinal sensitivity was 9.8 dB in eyes that underwent ILM peeling and 13.19 dB in eyes that did not undergo peeling; the difference was statistically significant (P = .0209).
Postoperative microscotomas were markedly more prevalent in eyes that underwent ILM peeling; the frequency of microscotoma was 11.3 points with retinal sensitivity below 10 dB in eyes that underwent peeling and 2.9 points in eyes that did not undergo peeling (P = .0093).