Ferenc Kuhn, Robert Morris, Viktoria Mester, Gyongyi Kiss, Zsuzsanna Szijarto, Balint Kovacs, Beatrix Cser


To evaluate the results and complications of internal limiting membrane (ILM) removal in the treatment of macular edema.


Retrospective and prospective studies on eyes undergoing vitrectomy with ILM removal for eyes with clinically significant macular edema.


Of the 68 eyes, follow-up (average: 9 months) was available on 64 eyes. The edema was caused by edema in 83%, uveitis in 5%, central retinal vein occlusion in 5% and other etiologies in 7%. Of the patients, 64% were males, aged 54 (6-77). The edema was cystoid in 56%. Complete edema resolution was achieved in 73%, partial in 22%; no change was seen in 4% and the edema recurred in one eye (2%). The average improvement on OCT was from 444 μ to 289 μ, a reduction of 37%. The visual acuity improved in 69% (at least 2 Snellen lines in 60%); 17% of eyes had worsened, all due to cataract or AMD development.


It appears that ILM removal improves the chance of visual recovery for eyes with macular edema, whether or not prior laser treatment has been attempted. Better initial visual acuity – i.e., earlier intervention – is associated with better outcomes. The rate of edema recurrence is low, but the best surgical technique and the optimal timing remain to be determined.

Take-home message:

ILM removal appears to increase the success and reduce the reoccurrence rate in eyes with macular edema.