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Kono Ryota, Yasser Helmy Mohamed, Yuki Maekawa, Ai Yoneda, Hirohumi Kinoshita, Yoshihisa Yamada, Eiko Tsuiki, Azusa Fujikawa, Takeshi Kumagami, Takashi Kitaoka; Effect and risk of internal limiting membrane peeling for idiopathic epiretinal membrane. Invest. Ophthalmol. Vis. Sci. 2019;60(9):5000.
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© ARVO (1962-2015); The Authors (2016-present)
The purpose of this study was to investigated the functional and anatomical results after vitrectomy for idiopathic epiretinal membrane (ERM) with and without internal limiting membrane (ILM) peeling.
In this prospective and comparative study, patients with idiopathic ERM were randomized into ERM removal with or without intentional ILM peeling. Best-corrected visual acuity (BCVA), retinal sensitivity (RS) measured using microperimetry, and central retinal thickness (CRT) measured using optical coherence tomography were evaluated preoperatively and postoperatively at 1, 3, and 6 months.
After the vitrectomy, ERM was removed with intentional ILM peeling (“with peeling” group). On the other hand, cases of ERM removal followed without intentional ILM peeling was divided into two groups: ILM was stayed in situ (“without peeling” group) and ILM was removed unintentionally with ERM removal (“with” group). Eventually, there were 45 eyes in the “with peeling” group and 9 eyes “without peeling” group. Result of “with peeling” group, BCVA improved (logMAR 0.27±0.18→0.08±0.14, p<0.0001) and CRT decreased (450±72μm→388±41μm, p<0.0001) at 6 months compared to before the vitrectomy. There was no significant difference in RS (15.9±1.9dB→15.6±2.0dB, p=0.86). Result of “without peeling” group, there was no significant difference in BCVA (logMAR 0.40±0.29→0.20±0.24, p=0.21), CRT (453±48μm→400±56μm, p=0.11), RS (13.5±2.2dB→14.6±3.0dB, p=0.69) at 6 months compared to before the vitrectomy. Comparison between both groups, there was no significant difference in BCVA, RS, and CRT at 6 months. ERM postoperative recurrence was observed in one case (2.2%) in “with peeling” group and two cases (22.2%) in “without peeling” group.
After vitrectomy for idiopathic ERM, ILM peeling improve visual acuity, retinal thickness, and reduce the risk of ERM recurrence, but not improve retinal sensitivity.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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