• Kunihiko Akiyama, Kaoru Fujinami, Ken Watanabe, Kazushige Tsunoda, and Toru Noda.
• Department of Ophthalmology, National Hospital Organization, Tokyo Medical Center, Tokyo, Japan; Laboratory of Visual Physiology, Division of Vision Research, National Institute of Sensory Organs, National Hospital Organization, Tokyo Medical Center, Tokyo, Japan. Electronic address: kakiyama@ntmc-hosp.jp.
• Am. J. Ophthalmol. 2016 Nov 1; 171: 1-10.

PurposeTo determine the efficacy of internal limiting membrane (ILM) peeling during vitrectomy for rhegmatogenous retinal detachment (RRD) regarding post-vitrectomy epiretinal membrane (ERM) development and visual outcomes.DesignRetrospective, interventional, comparative case series.MethodsSetting: Institutional.Study PopulationOne hundred and two consecutive eyes with RRD treated with vitrectomy and followed for at least 6 months. ILM was peeled without using dye such as indocyanine green (ICG). Observational Procedures: Patients were divided into 2 groups based on postoperative ERM development: Group 1, 81 eyes without ERM formation; Group 2, 21 eyes with ERM development. Patients also were divided into 2 subgroups: those with and without ILM peeling (58 and 44 eyes, respectively). Statistical analyses were performed between the 2 groups with/without ERM formation and between the 2 subgroups with/without ILM peeling for 5 preoperative factors including foveal involvement of the RRD, 4 intraoperative factors including ILM peeling, baseline best-corrected visual acuity (BCVA), and final BCVA.Main Outcome MeasuresAn association of ILM peeling with ERM prevention and the influence of ILM peeling on visual outcomes.ResultsILM peeling was significantly (P < .001) associated with ERM prevention. There was no significant difference in the final BCVA between subgroups with and without ILM peeling.ConclusionsILM peeling without ICG staining during the initial vitrectomy for RRDs may prevent postoperative ERM formation with favorable visual outcomes.Copyright © 2016 Elsevier Inc. All rights reserved.

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