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Y. Yokota, H. Hashimoto, A. Suzuki, S. Kishi; Internal Limiting Membrane Peeling Prevents Recurrence of Epiretinal Membrane in Vitrectomy for Macular Pucker . Invest. Ophthalmol. Vis. Sci. 2005;46(13):5441.
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Purpose: To compare a recurrence rate of epiretinal membrane(ERM) and postoperative visual function after vitrectomy for secondary macular pucker with or without peeling of internal limiting membrane(ILM). Methods: We defined macular pucker as secondary epiretinal membrane after ocular surgery, laser photocoagulation, uveitis and retinal angioma in this study. We reviewed 21 eyes of 21 patients with macular pucker which underwent vitrectomy at Gunma University Hospital from 2000 to 2003. Within the 21 eyes, ICG assisted ILM peeling was performed in 10 eyes (group 1) in addition to epiretinal membrane removal. Only epiretinal membrane removal without ILM peeling was performed in 11 eyes (group 2). Group 1 consisted of 6 eyes with retinal detachment surgery, one eye with vitrectomy for intraocular foreign body, 2 eyes with vitrectomy for proliferative diabetic retinopathy and one eye with retinal photocoagulation for branch retinal vein occlusion. Group 2 included 6 eyes with retinal detachment surgery, one eye with vitrectomy for intraocular foreign body, one eye with vitrectomy for fungal endophthalmitis, one eye with retinal angiomatosis and 2 eyes with ocular sarcoidosis. We compared the incidence of recurrent epiretinal membrane at 12 months after surgery. Results: Mild recurrence of epiretinal membrane occurred in one eye (10%) in group 1 and 6 eyes (56%) in group 2. Final postoperative visual acuity was improved in two lines or more in 7 eyes (70%) in group 1 and 4 eyes (36%) in group 2. Metamorphopsia was resolved after surgery in 6 eyes(60%) in group 1 and 2 eyes(18%) in group 2. Conclusions: A recurrence rate of ERM was significantly lower in eyes with ILM removal (group 1). Metamorphopsia was more improved in group 1. ICG assisted ILM peeling has a great advantage to prevent recurrence of epiretinal membrane in vitrectomy for macular pucker.
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