Internal limiting membrane peeling during vitrectomy for idiopathic epiretinal membrane: a meta‐analysis

Abstract

PurposeTo study the effect of internal limiting membrane (ILM) peeling in removal of idiopathic epiretinal membranes (ERMs) through meta‐analysis.MethodsWe searched PubMed for studies published until 30/4/2018. Inclusion criteria included cases of idiopathic epiretinal membranes, treated with vitrectomy with or without ILM peel. Exclusion criteria consisted of coexisting retinal pathologies and use of ICG to stain the ILM. We conducted a meta‐analysis of 16 published studies as well as a case series of 50 eyes with epiretinal membrane (ERM) treated in our department. We compared the results of surgical removal of epiretinal membrane, with or without ILM peel, in terms of best‐corrected visual acuity (BCVA) and anatomical restoration of the macula (central foveal thickness—CFT). Studies or subgroups of patients that had indocyanine green (ICG) used as an ILM stain were excluded from the study, due to evidence of its retinal toxicity.ResultsThere was a consistency in results for post‐operative/pre‐operative BCVA and CFT levels in both groups of patients (with or without ILM peel). In all cases, we found a statistically significant increase (p < 0.05) in post‐operative BCVA and decrease (p < 0.05) in post‐operative CFT levels versus pre‐operative levels.ConclusionsVitrectomy for the removal of ERM combined with ILM peeling is an effective method for the treatment of patients with idiopathic ERM.