Background: Epiretinal membranes (ERMs) have been reported after pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RRD). Peeling of the internal limiting membrane (ILM) can prevent post-PPV ERM formation but has a potential negative impact on macular structure and function. Purpose: To investigate the anatomical and functional outcomes of ILM peeling during PPV for primary RRD. Methods: This was a prospective nonrandomized study that included 60 eyes of 60 patients with a primary maculaoff RRD and less than grade C proliferative vitreoretinopathy (PVR). Eyes were allocated into 2 groups; Group A underwent PPV without ILM peeling and Group B had ILM peeling. At postoperative month 6, all patients underwent retinal imaging using spectral domain optical coherence tomography (OCT) and OCT angiography and macular function was assessed using multifocal electroretinogram (mfERG). Baseline characteristics and postoperative anatomical and visual outcomes were recorded and statistically analyzed. Results: We enrolled 30 eyes of 30 patients in each group. In Group A, mean age was 44.6 years, while the mean age of Group B patients was 49.9 years. Postoperative LogMAR visual acuity was significantly better in Group A than in Group B (p < 0.001). ERMs were demonstrated on OCT in 13.3% of Group A and none of Group B patients (p = 0.04). Retinal dimples were found in 53.3% of Group B and none of Group A eyes (p < 0.001). OCTA showed a greater vessel density of the superficial capillary plexus (SCP) in Group A compared to Group B eyes (p = 0.046), while no difference was found regarding deep capillary vessel density (p = 0.7). Mean amplitude of mfERG P1 wave was significantly higher in Group A eyes than in Group B (p = 0.002). Both the SCP vessel density and P1 amplitude were positively correlated with visual acuity (p < 0.001). Conclusion: This study suggests that ILM peeling prevents ERM development in eyes undergoing PPV for uncomplicated macula-off RRD, but potential damage to macular structure and function were found. Trial registration Retrospectively registered on 09/24/2019 on ClinicalTrials.gov with an ID of NCT04139811.

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Background: Laparoscopic bariatric surgery requires retraction of the left lobe of the liver for exposure of the hiatus and the stomach. The most common used methods are using the retractors that require another incisions and prolonged operative time. Objectives: A prospective assessment of the efficacy and safety of a percutaneous stone forceps without trocar for liver retraction in patients undergoing laparoscopic bariatric surgery. Methods: A prospective review was performed on 120 patients undergoing bariatric surgery from January2019 to January 2020 in Alhayat national hospital in Saudi Arabia gazan. A percutaneous stone forceps was used to retract the left lobe of the liver in all cases. The retractor can be changed as necessary by releasing and catching the diaphragm at different sites. Results: This technique was used in 120 patients from January2019 until january 2020. The average body mass index was 45 .In all patients, this method was found to be good and easy to complete the bariatric surgery. The majority of procedures included laparoscopic Roux-en-Y gastric bypass, sleeve gastrectomy. No intraoperative liver injuries occurred with use of this technique. Conclusion: this method of retraction of the liver using the stone forceps grasper found to be safe in the morbidly obese patients. The rate of complications is low. This method is safe and effective in retraction of liver with less trauma than conventional technique.