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IMPACT OF INNER LIMITING MEMBRANE PEELING ON VISUAL RECOVERY AFTER VITRECTOMY FOR PRIMARY RHEGMATOGENOUS RETINAL DETACHMENT INVOLVING THE FOVEA

Garweg, Justus G., MD*,†; Deiss, Mario, BMed; Pfister, Isabel B., MSc*,†; Gerhardt, Christin, Dipl-Psych*,†

doi: 10.1097/IAE.0000000000002046
Original Study: PDF Only

Purpose: To assess the impact of inner limiting membrane peeling during vitrectomy for macula-involving retinal detachment on best-corrected visual acuity (VA).

Methods: Retrospective analysis of 89 eyes with primary macula-involving retinal detachment, which was undergoing vitrectomy, endolaser, retinotomy, endodrainage, and SF6 tamponade. Membrane-blue-assisted membrane peeling had been performed in 61 of the eyes (Group 1) but not in the other 28 (Group 2), which served as controls.

Results: Age, lens status, and incidence of proliferative vitreoretinopathy 26.2% versus 39.3%; P = 0.23 in the 2 groups were comparable. The preoperative visual acuity (Early Treatment Diabetic Retinopathy Study letters) was 25.7 ± 27.9 in Group 1 and 28.8 ± 29.9 in Group 2 (P = 0.47). After surgery, these rose from 62.3 ± 30.5 (Group 1) and 34.2 ± 35.8 (Group 2) after 1 week (P = 0.090), through 83.1 ± 8.0 and 57.2 ± 32.4 at 1 month (P = 0.0005), to 92.1 ± 4.5 and 74.4 ± 23.1 Early Treatment Diabetic Retinopathy Study letters after 6 months (P = 0.0005). More than 6-month incidences of proliferative vitreoretinopathy (13.1% vs. 28.6%; P = 0.13) were similar, whereas the redetachment rate (9.8% vs. 32.1%; P = 0.014), the incidence of secondary epiretinal membranes (1.6% vs. 35.7%; P = 0.0005), and the revitrectomy rate were lower in group 1 (9.8% vs. 53.6%; P = 0.0005).

Conclusion: Inner limiting membrane peeling during vitrectomy for macula-involving retinal detachment may substantially contribute to the visual recovery, reducing the incidence of secondary epiretinal membrane formation.

*Swiss Eye Institute, Rotkreuz, and Berner Augenklinik am Lindenhofspital, Bern, Switzerland; and

University of Bern, Bern, Switzerland.

Reprint requests: Justus G. Garweg, MD, Berner Augenklinik am Lindenhofspital, Bremgartenstrasse 119, CH 3012 Bern, Switzerland; e-mail: justus.garweg@swiss-eye-institute.com

J. G. Garweg advises several pharmaceutical companies (Alcon, Allergan, Bayer, Novartis) and participates in a number of international, multicentre clinical studies that are sponsored by a few of these (Novartis, Bayer) in the fields of AMD and diabetic retinopathy. These activities had no bearing on the study that gave rise to the submitted article, for which J. G. Garweg received neither direct nor indirect financial support; nor has he conflicts of interest with any of the presented data. The remaining authors have no financial/conflicting interests to disclose.

© 2018 by Ophthalmic Communications Society, Inc.