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Residual Internal Limiting Membrane in Epiretinal Membrane Surgery
  1. Kaori Kifuku (kifuku{at}med.kyushu-u.ac.jp),
  2. yasuaki Hata (hatachan{at}med.kyushu-u.ac.jp),
  3. Ri-ichiro Kohno,
  4. Shuhei Kawahara,
  5. Yasutaka Mochizuki,
  6. Hiroshi Enaida,
  7. Ko-hei Sonoda,
  8. Tatsuro Ishibashi
  1. Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Japan
  2. Kyushu University, Japan
  3. Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Japan
  4. Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Japan
  5. Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Japan
  6. Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Japan
  7. Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Japan
  8. Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Japan

    Abstract

    Background/Aim: To examine the degree of residual internal limiting membrane (ILM) after epiretinal membrane (ERM) peeling.

    Methods: Sixty-one eyes of 59 patients with ERM were enrolled. After ERM peeling, residual ILM was visualized with Brilliant Blue G (BBG). The residual ILM pattern was divided into 3 groups: (1) residual type (ILM mostly remained), (2) half type (approximately half of ILM remaind), (3) no residual type (ILM mostly removed with ERM). If ILM remained, residual ILM was removed in all cases, and histologically examined with flat mount method in ten cases. The correlation between the degree of ERM evaluated by preoperative best corrected visual acuity (BCVA) and residual ILM pattern was also examined.

    Results: Twenty-eight eyes (45.9%) were the residual type. Three eyes (4.9%) were the half type, and thirty eyes (49.2%) were no residual type. Mean preoperative BCVA showed no significant correlation with the residual ILM pattern. Flat mount immunohistochemistry revealed many remnant cells, both GFAP positive and negative, on residual ILMs in all specimens examined. No recurrence that needed surgical treatment was observed.

    Conclusion: Residual ILM with remnant cells seems to be frequent after ERM removal. Intraoperative staining with BBG may be helpful in determining extent of ILM removal.

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