Membrane Peeling For Retinal Detachment Research Articles

Modified superior inverted internal limiting membrane flap technique with vitrectomy versus vitrectomy with internal limiting membrane peeling for retinal detachment with myopic macular hole

PurposeTo evaluate the efficacy of the modified superior inverted internal limiting (ILM) membrane flap technique in retinal reattachment, macular hole closure and external retinal layers restoration in macular hole associated retinal detachment compared to ILM peeling. MethodsRetrospective case series of 10 patients that required pars plana vitrectomy for retinal detachment with macular hole followed for more than 12 months. Data from medical records were retrospectively collected and patients were divided into the superior inverted flap (5 patients) and ILM peeling group (5 patients). We compared best corrected visual acuity (BCVA) before and after surgery, retinal attachment, macular hole closure rate and external retinal layer restoration between groups. ResultsThere were significant improvements in BCVA in both groups before and after surgery, with no differences between the two groups at 12 months after surgery (p=0.9). The macular hole closed in 100% of cases in the inverted flap group and 80% of the ILM peeling group with no significant differences between groups. The retina was reattached in 100% of cases in both groups. Only 2 patients in the inverted flap group (40%) had external retinal layer restoration and none in ILM peeling group (p=0.62). ConclusionsILM peeling and superior inverted flap techniques are useful for treating retinal detachment with macular hole in myopic eyes.

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

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.

Vitreoretinal surgery without internal limiting membrane peeling for retinal detachment with macular hole and high myopia

Objective To evaluate the efficacy of vitreoretinal surgery without internal limiting membrane (ILM) peeling for retinal detachment with macular hole and high myopia. Methods A total of 12 eyes of 11 patients of retinal detachment with macular hole and high myopia were analyzed retrospectively. They underwent vitreoretinal surgery from June 2012 to October 2014. The pars plana vitrectomy combined with silicon oil tamponade was performed without internal limiting membrane (ILM) peeling, and epiretinal membrane was peeled with Triamcinolone acetonide assistance during the surgery. After the surgery, the patients were kept face down position at least for 2 weeks. The follow-up time was 1 to 10 months. The condition of retina, macular hole and the visual acuity were observed. Results The retina was reattached in all the 12 eyes. The visual acuity improved in 11 eyes and remained unchanged in 1 eye. The macular of hole closed in 3 eyes. Conclusion The vitreoretinal surgery without ILM peeling combined with silicon oil tamponade is a minimally invasive and safe technique for retinal detachment with macular hole and high myopia. Key words: Myopia, high; Macular hole; Retinal detachment; Vitreoretinal surgery, Without internal limiting membrane peeling

Primary silicone oil tamponade and internal limiting membrane peeling for retinal detachment due to macular hole in highly myopic eyes with chorioretinal atrophy.

BackgroundRetinal detachment (RD) secondary to macular hole (MH) is a common complication in highly myopic eyes, usually leading to a poor visual prognosis. The purpose of this study was to evaluate the surgical outcome of silicone oil (SO) tamponade and internal limiting membrane (ILM) peeling in the treatment of RD caused by MH (MHRD) in highly myopic eyes with chorioretinal atrophy, and to identify clinical factors associated with the anatomical outcomes.MethodsWe retrospectively reviewed 21 eyes of 21 highly myopic patients affected by RD secondary to MH and chorioretinal atrophy. All eyes were treated with pars plana vitrectomy (PPV) with ILM peeling and SO tamponade. Anatomical success was defined as reattachment of the retina with the closure of the MH, as assessed by optical coherence tomography (OCT), after SO removal. Logistic regression was performed to determine the clinical factors influencing anatomical success.ResultsThe mean patient age was 59.95 years [standard deviation (SD), 10.39; range, 34–77 years] and the mean axial length was 30.58 mm (SD, 1.52; range, 27.99–34.51 mm). After the first surgical procedure, the anatomical success rate was 61.9 % (13 eyes in 21 eyes), with initial retinal attachment of16 eyes (76.2 %). A second surgical approach was performed for the five eyes with persistent or recurrent RD, and the final retinal reattachment rate was 100 % (21/21). Logistic regression analysis showed that no specific factors were significantly associated with anatomical success.ConclusionsPrimary silicone oil tamponade and ILM peeling can be a practical treatment for repairing MHRD in highly myopic eyes with chorioretinal atrophy.