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

Purpose:

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

Methods:

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

Results:

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.

Conclusion:

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.