Effects of internal limiting membrane peeling during vitrectomy for macula-off primary rhegmatogenous retinal detachment

Eur J Ophthalmol. 2018 Nov;28(6):706-713. doi: 10.1177/1120672117750055. Epub 2018 Mar 22.

Abstract

Purpose:: To determine the effectiveness of internal limiting membrane peeling during vitrectomy for macula-off primary rhegmatogenous retinal detachment in the prevention of postoperative epiretinal membrane formation and achievement of good visual outcomes and to identify preoperative and intraoperative risk factors for epiretinal membrane formation.

Methods:: We retrospectively analyzed data from 62 eyes of 62 consecutive patients with macula-off primary rhegmatogenous retinal detachment who underwent vitrectomy with (n = 30) or without (n = 32) internal limiting membrane peeling between January 2014 and March 2016 and were followed up for at least 12 months. The effects of internal limiting membrane peeling on visual outcomes and postoperative recovery of the macular structure were determined. We subsequently divided patients into an epiretinal membrane group and a non-epiretinal membrane group and assessed the effects of various preoperative and intraoperative factors on postoperative epiretinal membrane formation.

Results:: Postoperative epiretinal membrane developed in 10 patients in the no internal limiting membrane peeling group and three patients in the internal limiting membrane peeling group. Postoperative visual acuity significantly improved in both groups. Epiretinal membrane formation was found to be correlated with a higher number of retinal breaks.

Conclusion:: Our results suggest that internal limiting membrane peeling during macula-off primary rhegmatogenous retinal detachment surgery can reduce the occurrence of postoperative epiretinal membrane, is safe, and results in favorable visual outcomes.

Keywords: Best-corrected visual acuity; epiretinal membrane; internal limiting membrane; intraoperative factors; macula-off primary rhegmatogenous retinal detachment; macular edema; preoperative factors; risk factors; vitrectomy.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Basement Membrane / surgery*
  • Epiretinal Membrane / etiology
  • Epiretinal Membrane / prevention & control*
  • Epiretinal Membrane / surgery
  • Female
  • Humans
  • Macula Lutea / pathology
  • Male
  • Middle Aged
  • Postoperative Complications / prevention & control
  • Retinal Detachment / surgery*
  • Retinal Perforations / surgery
  • Retrospective Studies
  • Risk Factors
  • Tomography, Optical Coherence / methods
  • Visual Acuity
  • Vitrectomy / methods*