Journal List > J Korean Ophthalmol Soc > v.48(8) > 1007900

Kim and Kim: The Effect of Internal Limiting Membrane Peeling in Treatment of Idiopathic Epiretinal Membrane

Abstract

Purpose

This study was designed to evaluate the effect of internal limiting membrane (ILM) peeling in the surgical management of idiopathic macular epiretinal membrane (ERM).

Method

The records of 36 patients (36 eyes) with idiopathic macular ERM who had undergone pars plana vitrectomy with removal of the ERM were retrospectively reviewed. The patients were divided into two groups: eyes with (18 eyes) or without (18 eyes) ILM peeling. The best corrected visual acuity (BCVA), recurrence of ERM, persistence of retinal wrinkling, as well as the complications and improvement of visual acuity of the two groups were compared.

Results

The mean pre-operative BCVA for the two groups was 0.29 in the group with ILM peeling and 0.26 in the group without ILM peeling, while the mean post-operative BCVA was 0.59 and 0.50, respectively. Although the post-operative BCVA significantly improved in both groups (P=0.001), there was no statistically significant difference between the two groups (P>0.05). However, the persistence of retinal wrinkling greatly decreased in the group with ILM peeling, and ERM recurred in two cases in the group without ILM peeling.

Conclusion

ILM peeling in the surgical management of idiopathic macular ERM does not affect the postoperative results of visual acuity and complications, except for the persistence of retinal wrinkling and recurrence.

References

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Figure 1.
Postoperative improvement of visual acuity in two groups.
jkos-48-1067f1.tif
Figure 2.
Scattergram showing postoperative visual acuity change in two groups.
jkos-48-1067f2.tif
Table 1.
Patient demographic characteristics in two groups
  Group I Group II Total
Number of patients (male:female) 18 (7:11) 18 (9:9) 36 (16:20)
Age (average, years) 62.7 63.7 63.6
Lens status (phakic:pseudophakic) 17:1 18:0 35:1
Combined cataract surgery 3 (16.7%) 2 (11.1%) 5 (13.9%)
Follow-up duration (average, months) 28.1 22.8 25.7
(range, months) 8-68 6.5-48 6.5-68
Table 2.
Post-operative visual acuity according to pre-operative visual acuity
    Post-operative visual acuity
 
  Pre-operative visual acuity <0.1 0.1-0.3 >0.3 Total
Group I < 0.1 0 2 0 2
  0.1- 0.3 0 1 10 11
  > 0.3 0 1 4 5
Group II
< 0.1
0
2
2
4
  0.1- 0.3 0 5 3 8
  > 0.3 0 0 6 6
Total
 
0
11
25
36
Table 3.
BCVA in two groups
  Group I (ERM +ILM peeling) Goup II (ERM peeling) P value
Preoperative BCVA 0.29 0.26 0.315
Postoperative BCVA 0.59 0.50 0.222
P value 0.001 0.001  

Post-operative BCVA significantly improved in both groups. But there is no statistically significant difference between the two groups.

BCVA=best corrected visual acuity.

ERM=epiretinal membrane.

ILM=internal limiting membrane.

Table 4.
ERM recurrence and persistence of retinal wrinkling in two groups
  Group I (ERM +ILM peeling) Group II (ERM peeling) P value
ERM recurrence 0 (0%) 2 (11.1%) 0.169
Retinal wrinkling 8 (44.4%) 11 (72.2%) 0.002

Although ERM recurred in two cases of Group II, there was no statistically significant difference in both groups. Retinal wrinkling significantly decreased after surgery in ERM+ILM peeling group.

ERM=epiretinal membrane.

ILM=internal limiting membrane.

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