Elsevier

Ophthalmology

Volume 110, Issue 1, January 2003, Pages 62-64
Ophthalmology

Regular article
Macular pucker removal with and without internal limiting membrane peeling: pilot study

Presented in part at the annual meeting of the American Academy of Ophthalmology, New Orleans, Louisiana, November 2001.
https://doi.org/10.1016/S0161-6420(02)01440-9Get rights and content

Abstract

Objective

To investigate results of macular pucker surgery with and without internal limiting membrane (ILM) peeling.

Design

Retrospective noncomparative interventional case series.

Participants

Forty-four consecutive patients underwent pars plana vitrectomy to remove an idiopathic macular pucker by two surgeons from June 1999 to July 2000.

Intervention

During the vitrectomy, one surgeon removed only the macular epiretinal membrane (24 patients), whereas the other surgeon removed the macular epiretinal membrane and then performed an additional ILM peeling (20 patients).

Main outcome measures

Visual acuity and recurrence of macular pucker.

Results

Twenty-four (55%) patients underwent pars plana vitrectomy without ILM peeling, and 20 patients (45%) underwent pars plana vitrectomy with ILM peeling. Visual acuity improved or was unchanged in 79% of operated eyes without ILM peeling and 100% of operated eyes with ILM peeling (P = 0.01). Visual acuity improved 5 or more lines in 25% of operated eyes without ILM peeling and 30% of operated eyes with ILM peeling. At the final visit, 21% of eyes without ILM peeling at the initial surgery showed postoperative recurrent macular pucker or persistent contraction to the ILM, whereas none of the eyes with ILM peeling had evidence of this.

Conclusions

This pilot study provides evidence that peeling of the ILM during macular pucker surgery may not have deleterious effects.

Section snippets

Patients and methods

We performed a retrospective chart review (from two surgeons) of all patients who underwent pars plana vitrectomy for idiopathic macular puckers from June 1999 to July 2000. Institutional review board approval was not required for this retrospective series. Only eyes with idiopathic macular puckers were reviewed. Eyes with a history of retinal detachment, retinal vascular occlusion, uveitis, vitreous hemorrhage, trauma, and ocular tumors were excluded. Forty-four consecutive cases from these

Results

All 44 consecutive patients undergoing pars plana vitrectomy to remove idiopathic macular pucker had a postsurgical follow-up of 3 months’ or longer duration. The mean postsurgical follow-up for operated eyes without ILM peeling was 392 days, and the mean follow-up for eyes with ILM peeling was 384 days. The mean age for both groups was 69 years old.

Twenty-four (55%) patients underwent pars plana vitrectomy surgery without ILM peeling, and 20 patients (45%) underwent pars plana vitrectomy with

Discussion

Forty-four consecutive eyes with idiopathic macular pucker underwent pars plana vitrectomy. Twenty-four had removal of the macular pucker only, and 20 had removal of the macular pucker with an additional macular ILM. One surgeon did not intentionally remove the ILM for his 24 consecutive cases, and the other surgeon always removed the ILM for his 20 consecutive cases.

In this study, none of the eyes that had the additional ILM peeling developed recurrent macular puckers at the final visit,

References (9)

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