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. 2025 Apr 24;55(2):82-85.
doi: 10.4274/tjo.galenos.2025.67847.

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

Deniz Bağcı  1 , Cumali Değirmenci  1 , Filiz Afrashi  2
Affiliations

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

Deniz Bağcı et al. Turk J Ophthalmol. .

Abstract
in English, Turkish

Objectives: 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.

Materials and methods: 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.

Results: 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.

Conclusion: 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.

Amaç: Bu çalışmada, maküla tutulumu olan (“maküla-off”) ve silikon yağı endotamponad kullanılan retina dekolmanı hastalarında internal limitan membran (İLM) soyulmasının anatomik ve görsel sonuçlara etkisini değerlendirmek amaçlanmıştır.

Gereç ve yöntem: Ege Üniversitesi Göz Hastalıkları Kliniği’nde maküla-off retina dekolmanı nedeniyle ameliyat edilen 19 hastanın (Grup 1, İLM soyulan) 19 gözü ile 32 hastanın (Grup 2, İLM soyulmayan) 33 gözü çalışmaya dahil edilmiştir. Tüm hastalar cerrahi öncesi, cerrahi sonrası 1. ay ve silikon alımı sonrası 1. ayda detaylı oftalmolojik muayenenin yanında maküla optik koherens tomografi ile değerlendirilmiştir.

Bulgular: Grup 1’in ortalama yaşı 60,47±9,9 yıl, Grup 2’nin 57,56±10,63 yıl idi. Ortalama takip süresi 9,13±5,29 aydı. Cerrahi öncesi görme keskinlikleri Grup 1’de 1,6±1,3 minimum rezolüsyon açısının logaritması (logMAR, logarithm of the minimum angle of resolution), Grup 2’de 1,1±0,8 logMAR idi. Cerrahi sonrası 1. ayda görme keskinlikleri Grup 1’de 0,8±0,7 logMAR, Grup 2’de 0,7±0,7 logMAR idi (p=0,1). Cerrahi sonrası 1. ayda Grup 1’de epiretinal membran (ERM) gelişimi gözlenmezken, Grup 2’de 9 gözde ERM gelişimi görüldü. Silikon alımı sonrası görme keskinlikleri benzerdi (p=0,2). Santral foveal kalınlığı (μm) ve maküla hacimleri (mm3) her iki grupta da benzer sonuçlar verdi (p>0,05). Grup 2’de ERM gelişen 3 göze cerrahi müdahale yapıldı ve görme keskinlikleri arttı.

Sonuç: Maküla tutulumu olan retina dekolmanlarında İLM soyulması, ERM gelişimini önlemede etkili olabilir; ancak görme keskinliği üzerinde belirgin bir iyileşme sağlanamamıştır. Daha uzun takip süreleri ve daha geniş hasta grupları ile çalışmalara ihtiyaç vardır.

Keywords: Retinal detachment; epiretinal membrane; internal limiting membrane.

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Conflict of interest statement

Conflict of Interest: No conflict of interest was declared by the authors.

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