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

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.