Ferenc Kuhn, Robert Morris, Viktoria Mester, Gyongyi Kiss,

Purpose:

To present the rationale, indications, and techniques of internal limiting membrane (ILM) removal.

Methods:

Analysis of personal experience and videotape demonstration.

Results:

Surface traction relief is the primary reason for ILM peeling. A long list of indications for ILM removal exist today, including its original condition (hemorrhagic macular cyst in eyes with Terson syndrome) to prophylaxis of proliferative vitreoretinopathy. Various techniques are available for the removal, from forceps to fluidic separation (FILMS). Several staining materials exist that make the maneuver easier and less traumatic to patient and surgeon.

Conclusion:

Removal of the ILM is safe and effective, both as treatment and as prophylaxis. The list of indications is likely to increase in the future, and technical improvements are also expected to continue.

Take-home message:

ILM removal is an accepted procedure today, with a growing indication list and improving technology.