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Comparative Study of Visual Acuity, Features of Optical Coherence Tomography, and Recurrence Rate

De Novelli, Fernando J., MD*; Goldbaum, Mauro, MD, PhD*; Monteiro, Mario L. R., MD, PhD*; Bom Aggio, Fabio, MD, PhD; Takahashi, Walter Y., MD, PhD*

doi: 10.1097/IAE.0000000000001983
Original Study

Purpose: To study and compare visual acuity, foveal thickness, outer limiting layer, ellipsoid zone, and recurrence rate in patients undergoing removal of the epiretinal membrane with and without the removal of the internal limiting membrane (ILM).

Methods: Sixty-three patients who had the epiretinal membrane removed by a single surgeon were randomly assigned into 2 groups: Group 1 without additional removal of the ILM and Group 2 with removal of the ILM. Patients were followed up and evaluated at the first month, third month, and sixth month, postoperatively.

Results: Patients from both groups had a gradual improvement in their vision over time. There was no significant difference in the improvement in visual acuity between the two groups. About tomographic assessment of alterations, no significant differences were found between the groups; however, Group 1 had a higher relapse rate (17%) compared with Group 2 (3.6%) (P = 0.09).

Conclusion: Epiretinal membrane removal with and without ILM peeling shows similar functional and anatomical improvements, but the group in which the ILM was not removed seemed to have a higher recurrence rate.

In this randomized prospective study, the authors compare visual and anatomical outcomes of patients undergoing epiretinal membrane surgery with and without internal limiting membrane peeling. Although visual outcomes were similar, there was a trend toward higher recurrence rate in the group in which the internal limiting membrane was not removed.

*Division of Ophthalmology, University of São Paulo Medical School, São Paulo, Brazil; and

Department of Retina, Sadalla Amin Ghanem Hospital of Eyes, Joinville, Brazil.

Reprint requests: Fernando J. De Novelli, MD, Rua Camboriu 35, Joinville CEP 89216222, Brazil; e-mail:

None of the authors has any financial/conflicting interests to disclose.

F.J.D.N. and M.G. contributed equally to this work.

© 2019 by Ophthalmic Communications Society, Inc.