Effect of Internal Limiting Membrane Peeling on Macular Structure and Metamorphopsia Scores in Idiopathic Epiretinal Membrane Surgery

Abstract

Backgrounds and Objective: Pars Plana Vitrectomy (PPV) and epiretinal membrane (ERM) peeling is the standard surgical procedure of ERM surgery. However, the effect of adding Internal Limiting Membrane (ILM) peeling to the standard surgery on macular function and structure remains still controversial. This study was aimed at investigating the effect of ILM peeling on the macular function and structure in idiopathic ERM surgery. Method: Thirty-six eyes of 34 patients were evaluated in this prospective study. The patients were divided into two groups (ILM peeling and non-ILM peeling group). While the removal of ERM was undergone alone in 19 eyes, it was combined with ILM peeling in 17 eyes. Metamorphopsia scores Vertical Metamorphopsia (VM) and Horizontal Metamorphopsia (HM), were measured at preoperative and 4 months postoperatively. Results: There was a statistically significant decrease in metamorphopsia (VM and HM) scores in both groups after the surgery. However, no statistically significant difference was found between the two groups in terms of reduction in VM scores and HM scores after surgery. Conclusion: Our study indicated that ILM peeling combined with ERM did not affect metamorphopsia scores.

Pars Plana Vitrectomy with or without Internal Limiting Membrane Peel for Epiretinal Membrane: A Systematic Review and Meta-Analysis

“…In this subgroup, 11 studies reported on one or more outcomes comparing eyes receiving PPV with and without ILM peel, where studies included patients receiving simultaneous phacoemulsification [15,16,[24][25][26][27][28][29][30][31][32]. All outcomes were consistent with the primary analysis, except for the outcomes described herein.…”

“…A total of 7,686 studies underwent title and abstract screening, 395 underwent full-text screening and 19 studies reporting on 1,291 eyes at baseline were included in our meta-analysis (Fig. 1) [3,[15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32]. Six included studies were RCTs [17,23,[29][30][31][32], and 13 were observational studies [3,15,16,[18][19][20][21][22][24][25][26][27][28].…”

“…1) [3,[15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32]. Six included studies were RCTs [17,23,[29][30][31][32], and 13 were observational studies [3,15,16,[18][19][20][21][22][24][25][26][27][28]. All patients also underwent ERM removal.…”

“…In one study, patients in the non-ILM peel group received fovea-sparing ILM peel [31]. Seven studies used ICG to stain the ILM [3,15,16,[24][25][26][27], two studies used ICG or TA [20,28], one used ICG or trypan blue [22], two used trypan blue [30,31], one used trypan blue or brilliant blue [17], five used brilliant blue [18,19,23,29,32], and one used brilliant blue or TA [21]. The mean age of patients across treatment groups ranged from 62 to 77 years old.…”

“…Nineteen studies reported one or more outcomes comparing eyes receiving PPV with and without ILM peel [3,[15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32]. Across 17 studies, eyes receiving PPV with ILM peel (0.30 ± 0.31 logMAR, ~20/40 Snellen, n = 569) and without ILM peel (0.30 ± 0.31 logMAR, ~20/40 Snellen, n = 578) achieved a similar BCVA at last study observation (WMD = −0.01 logMAR, 95% CI = [−0.04, 0.03], p = 0.68, Fig.…”