http://www.evrs.eu/medias/2005/congress/Epiretinal-Membrane-(ERM)-Surgery:-with-and-without-Internal-Limiting-Membrane-(ILM)-Peeling.swf

Murat Oncel

Purpose:

To evaluate the clinical outcome and compare the recurrence rate of epiretinal membrane (ERM) after vitrectomy for idipathic epiretinal membrane removal with or without peeling of the internal limiting membrane (ILM).

Methods:

Fifty two eyes of 52 consecutive patients were incorporated in this study. Patients were randomized into two groups: group 1 (no=25) trypan blue-assisted ILM peeling was performed in addition to ERM removal, and group 2 (no=27) only ERM removal without ILM peeling was performed. The ILM was peeled with the aid of diamond dusted scraper, pick or forceps. We compared the incidence of recurrent epiretinal membrane at 12 months after surgery.

Results:

No ERM recurrence was found in group 1, and 10 eyes (37%) had ERM recurrence in group 2 at 12 months after surgery. Best corrected postoperative visual acuity was improved in two lines or more in 23 eyes (92%) in group 1, and 24 eyes (88%) in groupĀ 2. Postoperatively no retinal detachment occured in any patient. No complication were detected during the ILM peeling.

Conclusion:

Recurrence of ERM may be minimized by removing the ILM during surgery. The recurrence rate of ERM was much lower in eyes with ILM removal (group 1). Metamorphopsia was improved when ILM was removed (group 1). Trypan blue technically improves the surgeon’s ability to ensure that the entire ILM and ERM is removed and shortens the operative time, eliminates further proliferation and improves the final vision.

Take-home message:

Removing the ILM during epiretinal membrane surgery reduces the risk of recurrence of epiretinal membrane formation.