Jean-François Le Rouic, Didier Ducournau, Frank Becquet


To investigate visual acuity (VA) outcomes after internal limiting membrane (ILM) peeling in macular idiopathic epiretinal membrane (ERM), diabetic macular edema (DME), macular hole (MH), and chronic macular edema after branch retinal vein occlusion (BVO).


This report is an interventional case series and retrospective nonrandomized study. Records of 221 patients operated on for  ERM, 52 patients operated on for DME, 85 patients operated on for MH, and 58 patients operated on for BVO were reviewed. All patients were treated by a standard two-port pars plana vitrectomy with ILM removal. Analysis of the four groups was performed using postoperative best-corrected visual acuity (BCVA in LogMAR units) after at least six months.


Mean gain in LogMAR lines of VA was 2.4 for ERM, 2.5 for DME, 2.7 for MH, and 2.3 for BVO. The percentage of patients with postoperative visual improvement was 80.3% for ERM, 75% for DME, 82.1% for MH, and 77.6% for BVO. We found no statistical difference in mean gain or in the improvement level of VA in the four groups.


Vitrectomy with ILM peeling appears to have the same efficiency in these four macular diseases in term of visual acuity. This suggests a common physiopathological mechanism involving Müller cells.