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Related Concept Videos

Hearing01:31

Hearing

When we hear a sound, our nervous system is detecting sound waves—pressure waves of mechanical energy traveling through a medium. The frequency of the wave is perceived as pitch, while the amplitude is perceived as loudness.

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Related Experiment Video

Updated: May 25, 2026

Neuro-rehabilitation Approach for Sudden Sensorineural Hearing Loss
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Published on: January 26, 2016

Peel and peel again.

S K Gibran1, B Flemming, T Stappler

  • 1St Paul's Eye Unit, Royal Liverpool University Hospital, Prescot Street, Liverpool L7 8XP, UK. syedgibran@yahoo.com

The British Journal of Ophthalmology
|December 7, 2007
PubMed
Summary
This summary is machine-generated.

Internal limiting membrane (ILM) fragments were found in epiretinal membrane (ERM) specimens during macular pucker surgery. This suggests a secondary basement membrane may be present, making routine "double peeling" feasible.

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Area of Science:

  • Ophthalmology
  • Retinal Surgery

Background:

  • Epiretinal membrane (ERM) peeling is a common surgical procedure for macular pucker.
  • The internal limiting membrane (ILM) is often removed with the ERM, but its consistent presence within ERM specimens is debated.

Purpose of the Study:

  • To investigate the presence of ILM within ERM specimens obtained during a deliberate "double peel" technique for macular pucker.
  • To assess the feasibility and implications of separating ERM and ILM during surgery.

Main Methods:

  • Pars-plana vitrectomy with a "double peel" technique was performed on 17 eyes.
  • Epiretinal membranes (ERMs) and internal limiting membranes (ILMs) were stained with Trypan Blue and peeled separately.
  • Histological examination evaluated the presence of ILM in ERM specimens and ERM in ILM specimens.

Main Results:

  • A "double peel" was successful in all 17 cases.
  • Internal limiting membrane (ILM) fragments were identified in 29% (5/17) of epiretinal membrane (ERM) specimens.
  • Residual ERM or cellular remnants were found in some ILM specimens, with no observed clinical recurrence of ERM.

Conclusions:

  • The internal limiting membrane (ILM) can be present within epiretinal membrane (ERM) specimens, even when seemingly peeled separately.
  • This suggests the ILM in ERM may be a secondary basement membrane.
  • The surgical plane between the ERM and native ILM allows for routine "double peeling" in macular pucker surgery.