Internal limiting membrane peeling in retinal detachment complicated by grade B proliferative vitreoretinopathy

Abstract

PurposeTo specify the benefits of internal limiting membrane (ILM) peeling as a surgical adjunct in primary repair of retinal detachments (RD) complicated by grade B proliferative vitreoretinopathy (PVR).MethodsA retrospective comparative study included consecutive patients who underwent vitrectomy for primary RD complicated by grade B PVR between May 2010 and December 2015 at Nancy University Hospital (France). All patients were treated with SF6 or C2F6 gaz tamponade. The ILM was routinely peeled after staining from 2012. The best‐corrected visual acuity and spectral‐domain optical coherence tomography (SD‐OCT) were collected at 1 and 3 months postoperatively, looking for epiretinal membrane formation, macular oedema or photoreceptor damage.ResultsThirty seven eyes who underwent ILM peeling (group 1) and 38 eyes without ILM peeling (group 2) were included. At the end of follow‐up, anatomic success after single surgery was higher in group 1 (89%) than in group 2 (66%, p=0.03). Mean final visual acuity was 0.41 ±0.40 logMAR in group 1 versus 0.43 ±0.22 logMAR in group 2 (p=0.82). After 3 months follow up, we found no epiretinal membrane (ERM) formation on OCT scans in group 1 whereas 5 ERM (20%) were detected in group 2 (p=0.012). The 2 groups did not differ in terms of cystoid macular oedema occurence, macular thickness or photoreceptor damage.ConclusionsILM peeling at the macula during vitrectomy for the treatment of retinal detachment complicated by grade B PVR may prevent a second surgery for redetachment or macular pucker.