Role of ILM peeling during vitreo-retinal surgery for rhegmatogenous retinal detachment in the development of post operative epiretinal membrane: a randomised trial

Session Details

Session Title: Quick Fire Free Paper Session

Session Date/Time: Saturday 17/02/2018 | 11:45-13:00

Paper Time: 12:45

Venue: Ballroom II & III.

First Author: : D.Dubey INDIA

Co Author(s): :                                 

Abstract Details

Purpose:

To investigate the difference in the occurrence of postoperative epiretinal membrane (ERM) after vitreoretinal surgery for rhegmatogenous retinal detachment with and without internal limiting membrane peeling (ILM). To study effect of ILM peeling on macular architecture.

Setting:

Patients with rhegmatogenous retinal detachment requiring vitreoretinal surgery and presenting to the outpatient services and vitreoretinal clinic of Dr. Rajendra Prasad Centre for Ophthalmic Sciences, A.I.I.M.S. were recruited.

Methods:

A prospective, interventional, randomised trial involving 60 eyes of 60 patients who underwent vitreoretinal surgery for RRD. Of the subjects, 30 underwent VRSx without ILM peeling and 30 subjects with ILM peeling. The best corrected visual acuity, fundus photograph, and optical coherence tomography pictures were collected 3 months and 6 months postoperatively. The data was analyzed for the presence of ERM, comparison of visual acuity and any macular architectural changes.

Results:

Six out of thirty eyes (20%) developed a macular ERM in non ILM peeling group. None of the eyes in ILM peeling group developed a macular ERM, but an ERM outside the ILM peeled area was present in six of the thirty eyes (20%). There was no significant difference between the postoperative BCVA in the two groups. DONFL (Dissociated Optic Nerve Fiber Layer) appearance was seen in twelve out of the thirty eyes (40%) in ILM peeling group, but in none of the eyes in non ILM peeling group. It did not adversely affect the final BCVA. The postoperative CMT (central macular thickness) was more in the ILM peeling group, but it was not statistically significant.

Conclusions:

ILM peeling seems to prevent the occurrence of postoperative ERM in patients with RRD undergoing vitreoretinal surgery. ILM peeling does not adversely affect the final postoperative best corrected visual acuity. ILM peeling is associated with DONFL in a significant number of cases. There is no significant difference in the postoperative central macular thickness with or without ILM peeling during vitreoretinal surgery.

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