Application of internal limiting membrane peeling in proliferative retinopathy

Abstract

AIM: To describe the application and evaluate the effects of internal limiting membrane(ILM)peeling in patients underwent primary vitrcetomy for complicated proliferative vitreoretinopathy(PVR). METHODS: Totally 48 cases with serious PVR underwent vitrectomy were enrolled in this study. All these cases were divided into two groups: 23 cases in group A underwent vitrectomy with ILM peeling; 25 cases in group B underwent vitrectomy without ILM peeling. All patients underwent successful primary vitrectomy using silicone oil. After regular referral, silicone oil was removed, the retina reattached successfully. The results of slit lamp, optical coherence tomography(OCT), best corrected logarithm of minimal angle of resolution(logMAR)visual acuity pre and post operation and secondary epimacular membrane formation were observed and contrasted. Independent sample t-test, paired sample t-test, Pearson Chi-square test and Fisher's Exact test were used to analyze the significance of results with a P value ≤0.05 interpreted as statistically significance. RESULTS: Secondary epimacular membrane formation was found in one eye in group A, and seven eyes in group B after vitrectomy, the difference was significant. Central macular thickness was 188.36±45.53μm in group A, and 220.42±53.15μm in group B after the removal of silicone oil, the difference was significant. Macular edema was comparatively mild in group with ILM peeling. Image of macular morphology in OCT was more similar to the normal in group A. The final logMAR visual acuity was 1.38±0.60 in group A and 1.61±0.51 in group B, the difference was not significant between these two groups.CONCLUSION: ILM peeling may prevent the formation of secondary epiretinal membrane, is conducive to the recovery of retinal structure. This technology can be used in vitrectomy for PVR.

Keywords

• internal limiting membrane peeling
• vitrectomy
• retinal detachment
• proliferative vitreoretinopathy