Dominik Odrobina, Maciej Bednarski, Slawomir Cisiecki, Zofia Michalewska, Jerzy Nawrocki (Lodz, Poland)

Advantages:

To analyze the effect of internal limiting membrane (ILM) peeling on the anatomical and functional outcomes in patients undergoing retinectomy of 180 degrees to 360 degrees for retinal detachment with Grade D-1 PVR, paying particular role to development of macular pucker.

Methods:

Consecutive and prospective series of 84 eyes of 84 patients were included in the study. All eyes underwent retinectomy with silicone oil tamponade for PVR retinal detachment. In Group A (33 eyes) after complete vitrectomy and removal all visible ERM’s, we injected 0,15% trypan blue. After removal of trypan blue we injected perfluorocarbon liquid, the residual visible membranes were removed and ILM peeling was performed; in Group B (51 eyes) the ILM was left intact. We included only pseudophakic eyes during the first control visit after silicone oil removal. We observed a good functional and anatomical results in group A and in group B. No case of macular pucker was observed in Group A where the ILM was peeled but nine (9) patients in the group without membrane peeling developed macular pucker.

Effectiveness / Safety:

In our investigation, we proved that ILM peeling causes inhibition of the process of visible fibrosis. In all cases, after retinectomy with ILM peeling we did not find macular pucker, and epiretinal membranes were formed only by the margin of retinotomy in the place where ILM was not removed. In the group without membrane peeling, which confirmed our hypothesis.

Take home message:

ILM peeling may be a useful prophylaxis for macular pucker.