Evaluation of Vitrectomy with or Without Internal Limiting Membrane Peeling in Management of Macula off Rhegmatogenous Retinal Detachment

Document Type : Original Article

Authors

1 Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.

2 Department of Ophthalmology, Damietta Faculty of Medicine, Al-Azhar University, Damietta, Egypt.

Abstract

Background: The visual outcomes of adjuvant internal limiting membrane [ILM] peeling as compared with conventional vitrectomy without ILM peeling in Rhegmatogenous retinal detachment [RRD] are controversial.
Aim: This study aimed to assess the role of the internal limiting membrane peeling in macular reattachment and prevention of macular complications after vitrectomy in cases of macula off rhegmatogenous retinal detachment.
Patients and Methods: The present study is prospective and comparative. The study involved 30 eyes with macula off primary RRD and pars plana vitrectomy [PPV] with silicon oil injection was done. The eyes were divided into two groups: Group 1 consisted of 15 eyes without ILM peeling, and Group 2 consisted of 15 eyes with ILM peeling. Following silicone oil removal, the best corrected visual acuity and epiretinal membrane [ERM] formation was assessed.
Results: Thirty eyes from thirty individuals were enrolled in the present study; the average age of those who participated in Group 1 was 57.66 years, and in Group 2, it was 55.27 years. Eight men [53.3%] and seven women [46.7%] were in Group 1, while seven men [46.7%] and five women [33.3%] were in Group 2. When comparing the two groups pre and postoperative BCVA [Decimal] values, there was a noticeable improvement in both groups. Also, we revealed improvement of BCVA [Decimal] in group 1 at one week [P =0.006], three weeks [P= 0.011*], 3monthes [P =0.027], and six months [0.014] after PPV and SO in comparison with group 2. The final visual acuity at one month after SOR [P =0.01] was significantly improved in group 1; ERM was developed in group 1 in 4 cases [26.7%] and not developed in any case in group 2; there was a significant relation between ERM formation and size of the tear.
Conclusion: PPV is an effective procedure and has a high success rate in cases of macula off RRD, helping in successful retinal and macular reattachment. According to this study, ILM peeling can even lower the reoperation rate in eyes underwent PPV for macula off RRD by preventing ERM formation.

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