Evaluation of vitrectomy with or without internal limiting membrane peeling in management of macula off rhegmatogenous retinal detachment

Background: The visual outcomes of adjuvant ILM peeling as compared with conventional vitrectomy without ILM peeling in Rhegmatogenous retinal detachment (RRD) are controversialAim: to evaluate the role of internal limiting membrane peeling in macular reattachment and prevention of post vitrectomy macular complications in cases of macula off rhegmatogenous retinal detachmentPatients and methods: This is a Prospective comparative study. The study included 30 eyes with macula off rhegmatogenous retinal detachment who underwent pars plana vitrectomy and silicon oil injection. The cases classified into 2 groups, Group 1 without internal limiting membrane peeling and group 2 with internal limiting membrane peeling. Evaluation of best corrected visual acuity and epiretinal membrane formation after of silicone oil removal had been doneResults: This study included 30 eyes of 30 patients. The mean age of patients in group 1 was 57.66 years and in group2 was 55.27 years. There were 8 males (53.3%) and 7 females (46.7%) in group 1 and there were 7 males (46.7%) and 5 females (33.3%) in group 2. There was significant improvement of BCVA (Decimal) at all postoperative measurements when compared to preoperative value in two groups. There was significant improvement of BCVA(Decimal) in group 1 at one week (P =0.006), three weeks (P= 0.011), 3monthes (P =0.027) and six monthes (0.014) after PPV and SO .The final visual acuity at one month after SOR(P =0.01) was significantly improved in group 1. ERM was developed in group 1 in 4 cases (26.7%) and not developed in any case in group 2. There was significant relation between ERM formation and size of tear.Conclusion: PPV is an effective procedure with high success rate in cases of macula off RRD. This study suggested that ILM peeling prevents ERM formation after PPV and SO injection in cases of macula-off RRD