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Graefe's Archive for Clinical and Experimental Ophthalmology
Published in: Graefe's Archive for Clinical and Experimental Ophthalmology 2/2018

01-02-2018 | Retinal Disorders

Functional and structural outcomes of ILM peeling in uncomplicated macula-off RRD using microperimetry & en-face OCT

Authors: Mohamed Gaber Ahmed Mohamed Eissa, Mohamad Amr Salah Eddin Abdelhakim, Tamer Ahmed Macky, Mohamed Mahmoud Khafagy, Hassan Aly Mortada

Published in: Graefe's Archive for Clinical and Experimental Ophthalmology | Issue 2/2018

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Abstract

Purpose

To investigate functional and structural outcomes of internal limiting membrane (ILM) peeling during primary vitrectomy for uncomplicated macula-off rhegmatogenous retinal detachment (RRD).

Methods

In this prospective interventional randomized comparative study, 43 eyes (43 patients) were randomly divided into group A (20), and group B (23), with and without ILM peeling respectively. Patients were evaluated clinically, and by spectral-domain optical coherence tomography (SD-OCT) and microperimetry (MP) following silicone oil removal. Main outcome measures were functional—MP (mean and foveal retinal sensitivity; MRS, FRS) and best-corrected visual acuity (BCVA)—and anatomical—en-face image analysis (retinal dimples), and SD-OCT changes [epiretinal membrane (ERM), subretinal fluid (SRF), ellipsoid zone disruption, central subfoveal thickness (CSFT), and foveal contour].

Results

All eyes achieved complete postoperative attachment with mean BCVA 1.0 ± 0.4 logMAR (6/60) in group A, and 0.4 ± 0.4 logMAR (6/15) in group B (p < 0.001). MRS and FRS were significantly higher in group B (p = 0.037 and 0.036 respectively). En-face OCT showed retinal dimples in all patients in group A (29.17 ± 7.67 dimples), compared to none in group B (p = 0.007). ERM did not develop in any eye in group A, while it developed in 17.4% of eyes in group B (p = 0.05).

Conclusion

Although ILM peeling prevented ERM, it resulted in poorer visual outcome in these uncomplicated RRD cases, and might be better reserved only for complicated cases.
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Metadata
Title
Functional and structural outcomes of ILM peeling in uncomplicated macula-off RRD using microperimetry & en-face OCT
Authors
Mohamed Gaber Ahmed Mohamed Eissa
Mohamad Amr Salah Eddin Abdelhakim
Tamer Ahmed Macky
Mohamed Mahmoud Khafagy
Hassan Aly Mortada
Publication date
01-02-2018
Publisher
Springer Berlin Heidelberg
Published in
Graefe's Archive for Clinical and Experimental Ophthalmology / Issue 2/2018
Print ISSN: 0721-832X
Electronic ISSN: 1435-702X
DOI
https://doi.org/10.1007/s00417-017-3875-7

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