Journal d'ophtalmologie clinique et expérimentale
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Assessment of Visual Function in Patients with Retinal Detachment after Vitrectomy with and without ILM Peeling

Małgorzata Pietras-Trzpiel, Agnieszka Oleszczuk, Agnieszka Brzozowska, Cesare Forlini, Anselm Jűnemann and Robert Rejdak

Purpose: To determine the influence of peeling the internal limiting membrane (ILM) on visual acuity, M-Charts, visual field and OCT in patients with retinal detachment.
Methods: We have analyzed 63 patients in three groups. The first group (group B) consisted of 26 patients who underwent vitrectomy with ILM peeling performed after staining with Brilliant Peel. The second group (group G) consisted of 23 patients, in whom ILM peeling was performed after staining with indocyanine green. The third group (group Z) consisted of 14 patients in whom ILM peeling had not been performed. Ocular examination involved the assessment of visual acuity for distance and near vision, visual field testing, metamorphopsia quantification, dilated fundus exam and OCT.
Results: There was a statistically significant improvement in the postoperative best corrected visual acuity for distance vision in groups B (p=0.00007), G (p=0.0002) and Z (p=0.003). There were statistically significant differences in the prevalence of ellipsoid layer photoreceptors abnormalities between the groups (p=0.004), with more abnormalities in group Z (64%) as compared to groups B (20%) and G (17%). Statistical analysis also revealed significant differences in the epiretinal membrane (ERM) incidence between the three groups (p=0.02), with ERM occurring more frequently in group Z (29%) as compared to groups B (4%) and G (4%).
Conclusions: ILM peeling does not adversely or positively affect the distance and near vision, visual field and MCharts. Therefore ILM removal could be considered in only selected cases of “macula-off” retinal detachment.