Abstract
PurposeTo investigate the effects of internal limiting membrane (ILM) peeling on visual acuity (VA) after rhegmatogenous retinal detachment (RRD) surgery.MethodsThis retrospective analysis examined the medical records of patients with RRD who underwent vitrectomy at 26 institutions. To detect prognostic factors of VA at 6 months postoperatively (post-VA), multivariate linear regression was performed with post-VA as the objective variable; ILM peeling, sex, age, preoperative VA (pre-VA), intraocular pressure, axial length, duration of RRD, and cataract surgery served as explanatory variables. Recurrence of RRD and epiretinal membrane formation within 6 months postoperatively were compared between groups of patients with and without ILM peeling, among patients with macula-on and macula-off RRD.ResultsThe inclusion criteria were met by 523 eyes with a macula-on RRD and 364 eyes with a macula-off RRD. ILM peeling was performed in 85 eyes with a macula-on RRD and 57 eyes with a macula-off RRD. In eyes with a macula-on RRD, ILM peeling did not affect post-VA (p = 0.72). Vitrectomy without cataract surgery and poor pre-VA were significantly associated with poor post-VA (p = 0.01 and p < 0.001, respectively). In eyes with a macula-off RRD, ILM peeling, long duration of RRD, and poor pre-VA were significantly associated with poor post-VA (p = 0.037, p = 0.007, and p < 0.001, respectively). Recurrence of RRD and epiretinal membrane formation were similar between groups of patients with and without ILM peeling, among patients with macula-on and macula-off RRD. Retina sensitivity was not evaluated by microperimetry.ConclusionILM peeling did not affect post-VA in eyes with a macula-on RRD, whereas post-VA was worse in eyes with ILM peeling than in eyes without peeling, among eyes with a macula-off RRD.
Highlights
In eyes with a macula-off rhegmatogenous retinal detachment (RRD), Internal limiting membrane (ILM) peeling, long duration of RRD, and poor pre-visual acuity (VA) were significantly associated with poor post-VA (p = 0.037, p = 0.007, and p < 0.001, respectively)
Recurrence of RRD and epiretinal membrane formation were similar between groups of patients with and without ILM peeling, among patients with macula-on and macula-off RRD
ILM peeling did not affect post-VA in eyes with a macula-on RRD, whereas post-VA was worse in eyes with ILM peeling than in eyes without peeling, among eyes with a macula-off RRD
Summary
Vitrectomy is an effective treatment for rhegmatogenous retinal detachment (RRD), but an epiretinal membrane (ERM) may develop after surgery for RRD and secondary surgeries may be needed for ERM removal in some cases [1,2,3,4]. Internal limiting membrane (ILM) peeling during vitrectomy has been a common procedure for treating macular diseases such as macular hole or ERM. ILM peeling can effectively prevent recurrence of ERM after vitrectomy for ERM [5, 6]. ILM peeling during the primary surgery for RRD has been reported to prevent recurrence of ERM [3, 7]. Controversy remains regarding the effect of ILM peeling on visual outcomes following vitrectomy for RRD [2,3,4, 7, 11]. We investigate the effect of ILM peeling during primary vitrectomy for RRD on postoperative visual outcomes and ERM formation
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
