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The role of epiretinal membrane (ERM) : retina adherence in predicting spontaneous internal limiting membrane (ILM) peeling during ERM surgery

Session Details

Session Title: Vitreoretinal Surgery V

Session Date/Time: Sunday 20/09/2015 | 11:00-13:00

Paper Time: 11:16

Venue: Hermes

First Author: : P.Tranos GREECE

Co Author(s): :    N. Dervenis   S. Asteriadis   A. Vakalis        

Abstract Details

PURPOSE:To evaluate the frequency of spontaneous ILM peeling during removal of ERM and to associate it with different types of ERM adherence to inner retina based on their preoperative Spectral Domain Optical Coherence Tomography (SD-OCT) appearance.


Ophthalmica Eye Institute - Thessaloniki - Greece (


Prospective, interventional, case series of patients undergoing pars plana vitrectomy (PPV) for idiopathic, symptomatic ERM. All ERMs were classified based on the extent of ERM-macula adhesion on OCT, into 3 types: focal (less than 50%), broad (50-90%) and complete (greater than 90%). Spontaneous ILM peel was evaluated following removal of ERM and staining with brilliant peel. The extent of ILM absence over the fovea and macular quadrants was quantified by the surgeon on a scale 0-100%.


Thirty three consecutive subjects were included in the study. Simultaneous ILM peeling was identified in 81% of individuals which was total (100%) in 43% of the cases. Based on the type of ERM-macula adhesion, spontaneous ILM peel was observed in 70% of patients showing complete adhesion, 68% of patients with broad adhesion and 24% of patients with focal adhesion (p=0.007).


Simultaneous ILM peel is a frequent occurrence during ERM surgery, especially when there is broad or complete ERM-macula adhesion on SD-OCT. Thorough evaluation of preoperative SD-OCT may be a useful tool in determining a safer, more simplistic plan in ERM surgery.

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