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Randomized Controlled Trial
. 2023 Aug 1;43(8):1282-1290.
doi: 10.1097/IAE.0000000000003812.

INTERNAL LIMITING MEMBRANE PEELING IN PATIENTS UNDERGOING VITRECTOMY FOR TRACTIONAL RETINAL DETACHMENT SECONDARY TO DIABETIC RETIONPATHY

Ryan B Rush  1   2   3   4 , Pedro Luis Gomez  1 , Sloan W Rush  2   3 , Pedro Gomez Bastar  1
Affiliations
Randomized Controlled Trial

INTERNAL LIMITING MEMBRANE PEELING IN PATIENTS UNDERGOING VITRECTOMY FOR TRACTIONAL RETINAL DETACHMENT SECONDARY TO DIABETIC RETIONPATHY

Ryan B Rush et al. Retina. .

Abstract

Purpose: To assess the merits of internal limiting membrane (ILM) peeling during pars plana vitrectomy in subjects with a tractional retinal detachment secondary to proliferative diabetic retinopathy.

Methods: One hundred and ninety-one proliferative diabetic retinopathy subjects undergoing pars plana vitrectomy for the principal indication of tractional retinal detachment were enrolled into this randomized controlled trial. Study subjects were intraoperatively randomized into one of the following treatment groups: Cohort A patients underwent ILM peeling, whereas Cohort B patients did not undergo ILM peeling. The main outcome was postsurgical epiretinal membrane development at 6 months. The secondary outcome was attainment of ≥ 20/50 visual acuity (Snellen) at 6 months.

Results: One hundred and thirty-nine subjects underwent randomization and completed the study's 6-month trial period. Cohort A had 3.1% (2 of 64) of subjects developing an epiretinal membrane postoperatively, whereas Group B had 26.7% (20 of 75) of subjects developing an epiretinal membrane postoperatively at 6 months ( P < 0.001). Attainment of ≥ 20/50 visual acuity (Snellen) at 6 months was found in 21.9% (14 of 64) of subjects in Cohort A and 9.3% (7 of 75) of subjects in Cohort B ( P = 0.039).

Conclusion: Proliferative diabetic retinopathy patients undergoing pars plana vitrectomy for tractional retinal detachment have a lower frequency of postsurgical epiretinal membrane formation and a greater likelihood of attaining ≥20/50 Snellen visual acuity at 6 months when ILM peeling is conducted. Specialists may consider peeling of the ILM during pars plana vitrectomy an important surgical maneuver in this patient population.

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References

    1. Aras C, Arici C, Akar S, et al. Peeling of internal limiting membrane during vitrectomy for complicated retinal detachment prevents epimacular membrane formation. Graefes Arch Clin Exp Ophthalmol 2009;247:619–623.
    1. Rao RC, Blinder KJ, Smith BT, Shah GK. Internal limiting membrane peeling for primary rhegmatogenous retinal detachment repair. Ophthalmology 2013;120:1102–1103.e2.
    1. Nam KY, Kim JY. Effect of internal limiting membrane peeling on the development of epiretinal membrane after pars plana vitrectomy for primary rhegmatogenous retinal detachment. Retina 2015;35:880–885.
    1. Akiyama K, Fujinami K, Watanabe K, et al. Internal limiting membrane peeling to prevent post-vitrectomy epiretinal membrane development in retinal detachment. Am J Ophthalmol 2016;171:1–10.
    1. Forlini M, Date P, Ferrari LM, et al. Comparative analysis of retinal reattachment surgery with or without internal limiting membrane peeling to prevent postoperative macular pucker. Retina 2018;38:1770–1776.

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