To compare anatomical outcomes, visual acuity results and secondary epirretinal membrane formation rates in patients with macula-off retinal detachment with or without peeling of the internal limiting membrane (ILM).

Retrospective study including all patients who underwent vitrectomy for macula-off retinal detachment during the year 2012 in our department. Patients were divided in 2 groups according to whether the ILM was peeled or not. ILM peeling was routinely performed in all patients after October 2012. Anatomical outcome, Best Corrected Visual Acuity (BCVA), secondary epirretinal membrane formation rates and visual complaints were evaluated.

Eighty-five patients were operated in 2012 due to macula-off retinal detachment. ILM peeling was performed in 21 patients (Group 1). Mean patient age (± standard deviation SD) was 67.2±7.65 years for patients in Group 1 and 66.5±8.55 years for patients in group 2. Mean follow-up time was 18 months. There were no statistically significant differences between pre-operative visual acuity, retinal detachment duration or number of breaks between the 2 groups. All patients were rendered psudophakic at the time of vitrectomy. Successful anatomical results (complete retinal attachment without tamponading agent) was achieved after the first surgery in 91% of patients in group 1 and 95% in group 2. Only these patients were evaluated for secondary epirretinal membrane formation. At the final follow-up, epirretinal membranes were present in 8 patients (12,5%) in group 2 and 0% of patients in group 1. Four of these 8 patients underwent a second vitrectomy for removal of the epirretinal membrane. Seven patients in group 1 had complaints of metamorphopsia, this was statistically significant and higher than what was referred by patients in group 2. Final visual acuity was similar between both groups.

Internal limiting membrane peeling in macula-off retinal detachment seems to reduce the incidence of secondary epirretinal membrane formation. There was no difference in our series in final anatomical result or final visual acuity. There was no need for a second surgery for epirretinal membrane in any of the patients when ILM peeling was performed in the first surgery, however, metamorphopsia was more frequent in this group.