Internal Limiting Membrane Peeling During Idiopathic Epiretinal Membrane Removal

Roh, Miin; Kim, Esther Lee; Eliott, Dean; Yonekawa, Yoshihiro

doi:10.1177/2474126416687121

Cited by 4 publications

(9 citation statements)

References 60 publications

(83 reference statements)

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“…The formation of the ERM exposes the macula to anterior-posterior forces and tangential forces, the anterior-posterior forces can lead to macular thickening, while tangential forces can cause vascular dislocation in macular area. Although ILM peeling ensures complete removal of the cortical vitreous and ERM, it has been shown that ILM peeling and intraoperative staining with indocyanine green decreases retinal sensitivity [20]. We found by OCT-A, like idiopathic ERM, the blood ow signals of the SCP and DCP are also altered after surgery in the diabetic ERM [21].…”

Section: Discussionmentioning

confidence: 66%

Influence of ILM peeling on macular blood flow in patients with diabetic epiretinal membrane

Gou

You

et al. 2022

Preprint

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Background To study the effect of intraoperative internal limiting membrane(ILM)peeling on the macular vascular structure in patients with diabetic epiretinal membrane (ERM). Methods Patients with diabetic ERM were divided into an ERM + ILM peeling group (18 eyes) and an ERM peeling group (19 eyes), all of whom underwent standard vitrectomy and were followed up until 6 months postoperatively. Best-corrected visual acuity(BCVA), Central macular thickness (CMT), Vessel density (VD) and vessel length density (VLD) of the superficial as well as deep retinal capillary plexus were compared between the two groups. Results There was no significant difference in BCVA (P > 0.05) and CMT (P > 0.05) between the two groups. In the superficial capillary plexus (SCP), the change in VD (p = 0.106) and VLD (p = 0.438) was not affected by peeling the ILM, and there was no significant difference in VD (p = 0.162) and VLD (p = 0.391) between the two groups at month 6. For the deep capillary plexus (DCP), there was an effect of ILM peeling on the changes in VD (p = 0.024) and VLD (p = 0.012); peeling of the ILM delayed the recovery time of the VD and VLD, and the VD (p = 0.003) and VLD (p = 0.000)in the ERM + ILM peeling group at postoperative month 6 were lower than those in the ERM peeling group. Conclusion Intraoperative peeling of the ILM in patients with diabetic ERM delayed the improvement of blood flow signal in the DCP but did not affect the recovery of postoperative BCVA and CMT.

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Section: Discussionmentioning

confidence: 66%

Influence of ILM peeling on macular blood flow in patients with diabetic epiretinal membrane

Gou

You

et al. 2022

Preprint

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“…These include VA discrepancies attributed to damage to the underlying anatomic structures, such as the superficial retinal surface and nerve fiber layer. 10 Another concern is that damage to the Müller cell endplate in the macula can contribute to worse VA outcomes. 10,11 In a retrospective review of vitrectomy specimens, Sivalingam et al 12 found differences in VA outcomes favoring eyes without an ILM on histopathology.…”

Section: Discussionmentioning

confidence: 99%

“…10 Another concern is that damage to the Müller cell endplate in the macula can contribute to worse VA outcomes. 10,11 In a retrospective review of vitrectomy specimens, Sivalingam et al 12 found differences in VA outcomes favoring eyes without an ILM on histopathology. However, the number of eyes in the ILM group (n = 11 [26.8%]) was disproportionate to the number in the total cohort (N = 41).…”

Section: Discussionmentioning

confidence: 99%

Long-Term Outcomes of Vitrectomy for Idiopathic Epiretinal Membrane With Internal Limiting Membrane Removal in Patients With Good Preoperative Visual Acuity

Drummond,

Crosson,

Mason

2024

Journal of VitreoRetinal Diseases

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Purpose: To evaluate the long-term visual results of vitrectomy with epiretinal membrane (ERM) and internal limiting membrane (ILM) removal for idiopathic ERM in eyes with a preoperative visual acuity (VA) of 20/50 or better. Methods: This retrospective review of a consecutive case series comprised 337 patients. Of these, 36 eyes of 36 patients had ERM and ILM removal from 2017 to 2018. Inclusion criteria included a subjective decrease in VA, a preoperative VA of 20/50 or better, vitrectomy with ERM and ILM removal for ERM, and a minimum 6-month follow-up. Paired t tests were used to determine the statistical significance ( P < .05) of VA changes postoperatively. Results: The mean (±SD) best-corrected logMAR VA improved to a maximum of 0.125 ± 0.09 (Snellen equivalent 20/26.4) at a mean of 11.1 months postoperatively ( P < .001). The VA continued to significantly improve over the long term (mean, 41.6 months; range, 6-63; P < .001). Overall long-term data trended heavily toward VA improvement (25/36 patients [69.4%]) and stability (10/36 patients [27.7%)] after ERM and ILM removal, with only 1 patient (2.8%) having worse VA. There were no intraoperative or postoperative complications related to ERM and ILM removal. Conclusions: Surgery to remove idiopathic ERM and ILM for patients with significant symptoms and good preoperative VA may result in excellent long-term visual results.

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“…Although the availability of stains for the ILM has made peeling safer, the procedure is still not free of complications. These include: retinal edema, nerve fiber layer damage, retinal hemorrhages, electrophysiological shifts and visual field changes have all been documented after ILM peeling 19,20,21 .…”

Section: Discussionmentioning

confidence: 99%

Comparison of epiretinal membrane peel after dual staining versus en bloc peel using negative staining technique

2020

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Purpose: To compare the completeness of ILM peel in cases of Idiopathic Epiretinal Membranes following double staining and double peeling versus en bloc dissection of both using negative staining method. Study Design: Quasi experimental study. Place and Duration of Study: Jinnah Hospital Lahore, from October 2017 to March 2018. Material and Methods: Forty eyes of forty patients with Idiopathic Epiretinal membranes (ERM) were selected by non-probability convenient method and divided into two groups. In group A, the ERM was initially stained with Trypan blue and then peeled. Subsequently the macula was re-stained with Brilliant blue G (BBG). In group B, ERM and ILM were successfully peeled together as a single membrane utilizing the single block technique, after a desired negative staining effect was obtained by injecting BBG. The thoroughness of the ILM peel was established using another injection of BBG although a few remains were often identified outside the central macular area, no other dyes were used. Results: In group A, 8 of the 20 eyes (40%) had full undisturbed ILM present whereas in 10 eyes (50%) the ILM was there but damaged, only 2 eyes (10%) had near total ILM removed. In group B, the dual peeling was successful in 17 of the 20 cases (85%). There has been no recurrence of ERM until now. Conclusion: Instead of peeling twice, the single en bloc negative staining technique with Brilliant blue G is a safer and more effective method for removal of ERM together with ILM.

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Internal Limiting Membrane Peeling During Idiopathic Epiretinal Membrane Removal

Cited by 4 publications

References 60 publications

Influence of ILM peeling on macular blood flow in patients with diabetic epiretinal membrane

Influence of ILM peeling on macular blood flow in patients with diabetic epiretinal membrane

Long-Term Outcomes of Vitrectomy for Idiopathic Epiretinal Membrane With Internal Limiting Membrane Removal in Patients With Good Preoperative Visual Acuity

Comparison of epiretinal membrane peel after dual staining versus en bloc peel using negative staining technique

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