INTERNAL LIMITING MEMBRANE PEELING VERSUS NO PEELING IN PRIMARY VITRECTOMY FOR MACULA OFF RHEGMATOGENOUS RETINAL DETACHMENT: A COMPARATIVE STUDY

Abstract

Purpose: To compare the visual outcome and the rate of epiretinal membrane formation after primary vitrectomy with internal limiting membrane peeling Vs no peeling for patient with macula off retinal detachment. Patients and methods: This was a Prospective comparative uncontrolled case series. The study enrolled 30 eyes with rhegmatogenous retinal detachment with macula off subjected to primary vitrectomy, and classified into 2 groups, Group A cases subjected to primary vitrectomy without internal limiting membrane peeling and group B cases subjected to primary vitrectomy, with internal limiting membrane peeling, Assessment of best corrected visual acuity and rate of epiretinal membrane formation after removal of silicone oil had been done. Results: This study included 30 eyes of 30 patients, 16 (53.33 %) were males and 14 (46.67 %) were females, the mean age of studied patients was (43.37 ± 10.40) years old. There was no statistically significant difference in mean logMAR BCVA after silicone oil removal (1.18 ± 0.29 for group A versus 0.99 ± 0.38 for group B; P = 0.12).OCT done for all cases after silicone oil removal after 6 months and show that; epiretinal membrane with cystoid macular edema is formed in 5 cases in group A while ERM is not formed in any cases in group B (P = 0.04) , IS / OS line is interrupted in 6 cases in group A and in 3 cases (P = 0.43) as regarding foveal contour; it is lost in 5 cases and preserved in 10 cases in group A while in group B the foveal contour is preserved in 13 cases ,lost in 1 case and flat in 1 case (P = 0.06) , while comparing the mean of the central foveal thickness shows no statistically significant difference 295.73±129.46 for group A versus 237.6±47.60 for group B; P = 0.66. Conclusion: There was no statistically significant difference in mean visual acuity after silicone oil removal in both procedures however, the epiretinal membrane formation was absent in group B with ILM peeling in comparison to group A.