To compare postoperative photoreceptor status and visual outcome after epiretinal membrane (ERM) removal with or without additional internal limiting membrane (ILM) peeling


Medical records of forty eyes from 37 patients undergoing ERM removal with residual ILM peeling (additional ILM peeling group) and 69 eyes from 65 patients undergoing ERM removal without additional ILM peeling (no additional peeling group) were reviewed. The length of defects in cone outer segment tips (COST), inner segment/outer segment (IS/OS) junction, and external limiting membrane (ELM) line were measured using spectral-domain optical coherence tomography images of the fovea before, and 1, 3, 6, and 12 months after surgery.

Effectiveness / Safety:

COST and IS/OS junction line defects were most severe at postoperative 1 month and gradually restored at 12 months postoperatively. The COST line defect in the additional ILM peeling group was significantly greater than that in the no additional peeling group at postoperative 1 month (P = 0.006), and BCVA was significantly worse in the former group at the month (P = 0.001). There were no significant difference in the defect size and BCVA at subsequent visits and recurrence rates between the two groups. Patients who received ERM surgery without additional ILM peeling showed better visual and anatomical outcome than those with additional ILM peeling at postoperative 1 month. However, surgical outcomes were comparable between the groups, thereafter. In terms of visual outcome and photoreceptor integrity, additional ILM peeling might not be an essential procedure.