Idiopathic Macular Epiretinal Membrane:Associated With Or Without Internal Limiting Membrane Peeling

Purpose: Idiopathic macular epiretinal membrane(IMEM)is one of the most important reasons for the elderly vision decreasing.In this study,we evaluate the visual and anatomical outcomes to compare vitrectomy combined with or without internal limiting membrane(ILM)peeling,and find the better one for the clinical treatment.Methods: In this randomized clinical trial,46 eyes of 46 patients affected with IMEM were enrolled.23 eyes underwent pars plana vitrectomy associated with phaco and IOL implantation and associated with ILM peeling(“ILM peeling group”),whereas 23 eyes did not undergo ILM peeling(“ILM not peeling group”).Patients will follow up at least 6 month,and the follow-up will contain: logMAR best corrected visual acuity(BCVA),mean retinal sensitivity(MS),scotoma points(SP),fixation within 2° and 4°(F2/F4),central macular thickness(CMT),the integrity of the ellipsoid zone(EZ),and postoperative complications.Results: 6 months after surgery,logMAR BCVA was significantly improved(P = 0.003,P = 0.014)in both ILM peeling group and ILM not peeling group;the MS of 2 groups were significantly higher after surgery(P = 0.000,P = 0.000);the SP and the fixation within 2° and 4°of 2 groups were not significantly increased after surgery;the CMT of 2 groups were significantly thinner after surgery(P = 0.000,P = 0.000);the number of EZ discontinuous cases have increased significantly 1 month after surgery in ILM peeling group(P = 0.003),but there are no significant difference 6 months postoperative(P = 0.536,P = 0.753)in both 2 groups.6 months after surgery,comparing the two groups,the MS for ILM peeling group was significantly lower than that for ILM not peeling group(P = 0.034);the SP for ILM peeling group was significantly more than that for ILM not peeling group(P = 0.009),and the CMT for the former was also thicker(P = 0.017).There were no difference between the two groups for logMAR BCVA,fixation within 2° and 4°,and the number of EZ discontinuous cases after 6 months.Conclusion: Both vitrectomies combined with or without ILM peeling can safely and effectively treat IMEM.But peeling ILM leads lower MS,more SP,and thicker CMT.We did not observe the recurrence during follow-up period.The ILM removal did not demonstrate its superiority in the short term.