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Extensive internal limiting membrane peeling for proliferative vitreoretinopathy.

Anibal Francone1, Martín Charles2

  • 1Retina Division, Centro Oftalmológico Dr Charles S.A., Riobamba 841, C1116ABA, Buenos Aires, Argentina. anibalfrancone@live.com.ar.

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Brilliant Blue G (BBG) assisted internal limiting membrane (ILM) peeling effectively reattached retinas in proliferative vitreoretinopathy (PVR) cases. This technique facilitated complete membrane removal, reducing retinal detachment recurrence risk.

Keywords:
3D visualization systemBrilliant blue GInternal limiting membrane peelingProliferative vitreoretinopathyRetinal detachment

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Area of Science:

  • Ophthalmology
  • Retinal Surgery
  • Surgical Innovation

Background:

  • Proliferative vitreoretinopathy (PVR) presents significant challenges in retinal reattachment.
  • Standard surgical techniques for PVR can be limited by incomplete membrane removal.
  • The internal limiting membrane (ILM) often harbors PVR membranes, complicating surgical outcomes.

Purpose of the Study:

  • To evaluate the anatomical outcomes of extensive internal limiting membrane (ILM) peeling using Brilliant Blue G (BBG) dye.
  • To assess the efficacy of BBG-assisted ILM peeling in proliferative vitreoretinopathy (PVR) under 3D visualization.
  • To determine if this technique improves retinal reattachment rates in complex PVR cases.

Main Methods:

  • Retrospective case series of 14 patients with PVR undergoing pars plana vitrectomy.
  • Selective staining of the ILM with BBG dye for enhanced visualization.
  • Extensive ILM peeling beyond vascular arcades combined with 3D visualization.
  • Anatomical success defined as persistent retinal reattachment post-silicone oil removal.

Main Results:

  • Anatomical success was achieved in 78.6% of eyes after a single surgery.
  • Eventual anatomical success was achieved in all treated eyes.
  • Mean follow-up was 12.3 months, with visual acuity improving from 2.93 logMAR to 1.75 logMAR.

Conclusions:

  • Extensive ILM peeling with BBG creates a crucial cleavage plane for complete PVR membrane removal.
  • This technique significantly aids in achieving anatomically reattached retinas and reduces PVR recurrence.
  • Further research is warranted to understand the long-term effects of this surgical approach.