Internal limiting membrane peeling in vitrectomy surgery for rhegmatogenous retinal detachment with silicone oil tamponade

Relevance In the structure of primary visual disability, rhegmatogenous retinal detachment (RRD) occupies one of the leading places. The development of epiretinal membrane (ERM) after vitrectomy for RRD worsens functional outcomes after surgery. There is no consensus on peeling of the internal limiting membrane (ILM) in RR surgery. Objective To evaluate the development of epiretinal membrane in patients after vitrectomy with silicone oil endotamponade with ILM peeling and without it. Material and methods Object of the study: 58 patients (58 eyes) with rhegmatogenous retinal detachment involving the macula, who received surgical treatment in the volume of ERM with endotamponade with silicone oil in the Federal State Budgetary Institution Pirogov National Medical and Surgical Center. Patients were divided into 2 groups. The first group included 47 patients without ILM peeling, the second group included 11 patients with ILM peeling. Results ERM was detected only in 14 patients of the second group (29.78%), in the first group there were no cases. In the second group, over the course of 1 year, 4 patients were diagnosed with grade 1 ERM, 8 patients with grade 2 ERM, and 2 patients with grade 3 ERM. No patients were diagnosed with grade 4 ERM, since with grade 3 ERM, patients underwent VRS with ERM peeling. In case of ERM detection before silicone oil removal, ERM was removed at the second stage of surgery (VRS, SM removal, ERM peeling), there were 7 such patients (14.89%). VRS with ERM and ILM peeling for ERM as the 3rd stage of surgery was performed in 3 patients (6.38%). In our study, ERM was removed in 10 patients of the 2nd group (21.27%), of which 2 patients had a recurrence of ERM during the entire observation period. Conclusion ILM peeling is effective for the prevention of ERM. Recurrence of ERM is possible with ERM removal without ILM peeling. Keywords: vitrectomy; macula; retinal detachment; internal limiting membrane; ILM peeling