The Effect of Internal Limiting Membrane Peeling on Anatomical and Visual Outcomes in Patients with Macula-Off...

This study aimed to evaluate the anatomical and visual outcomes of internal limiting membrane (ILM) peeling in patients with macula-involving ("macula-off") retinal detachment treated with silicone oil endotamponade.

The study included 19 eyes of 19 patients (Group 1, ILM peeled) and 33 eyes of 32 patients (Group 2, ILM not peeled) who underwent surgery for macula-off retinal detachment at Ege University Department of Ophthalmology. All patients underwent detailed ophthalmological examination and macular optical coherence tomography preoperatively, at postoperative 1 month, and 1 month after silicone removal.

The mean age was 60.47±9.9 years in Group 1 and 57.56±10.63 years in Group 2. The average follow-up duration was 9.13±5.29 months. Preoperative visual acuity was 1.6±1.3 logarithm of the minimum angle of resolution (logMAR) in Group 1 and 1.1±0.8 logMAR in Group 2. At postoperative 1 month, visual acuity was 0.8±0.7 logMAR in Group 1 and 0.7±0.7 logMAR in Group 2 (p=0.1). At 1 month postoperatively, epiretinal membrane (ERM) development was not observed in Group 1, while 9 eyes in Group 2 developed ERM. Visual acuity after silicone removal was similar in both groups (p=0.2). Central foveal thickness (μm) and macular volumes (mm³) were comparable in both groups (p>0.05). Three eyes in Group 2 that developed ERM underwent surgery and their visual acuity improved.

ILM peeling during vitreoretinal surgery in cases of macula-off retinal detachment may be effective in preventing ERM formation, though it does not result in significant visual improvement. Further studies with longer follow-up and larger patient cohorts are needed.