Internal Limiting Membrane Peeling in Macula-off Retinal Detachment Complicated by Grade B Proliferative Vitreoretinopathy

Abstract

To investigate the clinical benefit of internal limiting membrane (ILM) peeling as a surgical adjunct in the repair of primary retinal detachment (RD) complicated by grade B proliferative vitreoretinopathy (PVR). Retrospective, interventional, comparative case series. Setting, study population, observationalprocedures and Main outcome measures. Institutional. Seventy-five consecutive patients who underwent vitrectomy for primary macula-off RD complicated by grade B PVR. Patients were divided into an ILM peeling (Group P) and a no ILM peeling group (Group NP). Anatomic success rate, best-corrected visual acuity, and spectral-domain optical coherence tomography (SD-OCT) characteristics were collected at 1 and 6months. In all, 37 eyes with ILM peeling were included in Group P and 38 eyes without ILM peeling were included in Group NP. The anatomic success rate after single surgery was higher in Group P (89%) than in Group NP (66%, P= .03). Mean final visual acuity was 0.41 ± 0.40 logMAR in Group P vs 0.43 ± 0.22 logMAR in Group NP (P= .82). We found no epiretinal membrane (ERM) formation in Group P, whereas 5 cases of ERM (20%) were detected in Group NP (P= .012). The 2 groups did not differ in terms of cystoid macular edema occurrence, macular thickness, or photoreceptor damage. ILM peeling during vitrectomy in macula-off RD complicated by grade B PVR reduces the need for a second surgery for redetachment or macular pucker.