Effect of Internal Limiting Membrane Peeling on Functional and Structural Outcome of Pars Plana Vitrectomy for Rhegmatogenous Retinal Detachment

Abstract

Objective: The purpose of this study was to evaluate the effect of internal limiting membrane peeling on visual acuity and structural macular surface anatomy in patients with rhegmatogenous retinal detachment.

Methodology: A total of 20 patients divided in 2 equal Groups A and B comprising of 10 patients each were included in this study. All patients had rhegmatogenous retinal detachment of less than one month duration with minimal or no proliferative retinopathy. Both Groups A and B underwent pars plana vitrectomy and silicone oil / gas tamponade with Group A also undergoing internal limiting membrane peeling as an adjunct to surgery. A minimum of 6 months followup was planned for both groups to evaluate and compare the effect of internal limiting membrane peeling on visual acuity and epiretinal membrane formation at end of 6 months.

Results: At the end of 6 months followup, there was statistically significant difference in pre and post operative visual acuity in both the groups (p-value <0.001). But there was no difference in post operative visual acuity in both groups when evaluated for the effect of internal limiting membrane peeling (p-value=0.27). Also, the frequency of epiretinal membrane formation in Group A was significantly less when compared to group B.

Conclusion: We did not find ILM peeling as a useful adjunct to retinal reattachment surgery for improving post operative best corrected visual acuity. Although internal limiting membrane peeling had statistically significant results in preventing post operative epiretinal membrane formation. Internal limiting membrane peeling should be reserved for those cases only where epiretinal membrane already exists before retinal reattachment surgery.