Internal Limiting Membrane Peeling in Macula-off Retinal Detachment Complicated by Grade B Proliferative Vitreoretinopathy

PURPOSE: To investigate the clinical benefit of internal limiting membrane (ILM) peeling as a surgical adjunct in the repair of primary retinal detachment (RD) complicated by grade B proliferative vitreoretinopathy (PVR). DESIGN: Retrospective, interventional, comparative case series. METHODS: Setting, study population, observational procedures and Main outcome measures. SETTING: Institutional. STUDY POPULATION: Seventy-five consecutive patients who underwent vitrectomy for primary macula-off RD complicated by grade B PVR. OBSERVATIONAL PROCEDURES: Patients were divided into an ILM peeling (Group P) and a no ILM peeling group (Group NP). MAIN OUTCOME MEASURES: Anatomic success rate, best-corrected visual acuity, and spectral-domain optical coherence tomography (SD-OCT) characteristics were collected at 1 and 6 months. RESULTS: In all, 37 eyes with ILM peeling were included in Group P and 38 eyes without ILM peeling were included in Group NP. The anatomic success rate after single surgery was higher in Group P(89%) than in Group NP (66%, P = .03). Mean final visual acuity was 0.41 +/- 0.40 logMAR in Group P vs 0.43 +/- 0.22 logMAR in Group NP (P = .82). We found no epiretinal membrane (ERM) formation in Group P, whereas 5 cases of ERM (20%) were detected in Group NP (P = .012). The 2 groups did not differ in terms of cystoid macular edema occurrence, macular thickness, or photoreceptor damage. CONCLUSIONS: ILM peeling during vitrectomy in macula-off RD complicated by grade B PVR reduces the need for a second surgery for redetachment or macular pucker. (C) 2018 Elsevier Inc. All rights reserved.