Comparative Analysis of Retinal Reattachment Surgery with or Without ILM Peeling to Prevent Post-op Macular Pucker



To determine whether internal limiting membrane (ILM) peeling during pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RRD) reduces the incidence of epiretinal membrane (ERM) formation.


In this retrospective study, preoperative, intraoperative and postoperative data from all eyes undergoing PPV for RRD between January 2007 to December 2013 was analyzed. All cases with at least one-year follow up were included. Data collection included vision, intraoperative complications, occurrence of ERM and spectral domain optical coherence tomography (SD-OCT) characteristics. The OCT scans were retrieved for all eyes and were graded by a single masked grader.


Out of 159 eyes recruited, ILM peeling was done in 78 eyes (49%). Overall occurrence of ERM was 20%. Seven eyes (9%) in ILM peeling group and 25 eyes in the non-ILM peeling group (31%) showed ERM (p=0.001). Postoperative vision was significantly better in eyes that had ILM peeling (0.48+0.4 logMAR vs. 0.77+0.6 logMAR, P=0.003). In multivariable models adjusting for type of tamponade, ILM peeling reduced the likelihood of ERM formation by 75% (P=0.01).


Internal limiting membrane peeling during PPV for RRD significantly reduces ERM formation in the postoperative period and is associated with better visual and anatomical outcomes.



Matteo Forlini
Parma, Italy
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