Randomized Trial Comparing Micro-Serrated versus Conventional Internal Limiting Membrane Forceps for Internal Limiting Membrane Peeling

Abstract

Purpose: To evaluate macular findings and surgeon evaluation regarding the use of micro-serrated (SharkskinTM, Alcon, Forth Worth, TX) internal limiting membrane (ILM) forceps compared to conventional (Grieshaber® (Alcon)) ILM forceps for peeling of the ILM. Methods: Patients were prospectively assigned in a 1:1 randomized fashion to undergo ILM peeling using the micro-serrated forceps or conventional forceps. Rates of retinal hemorrhages, deep retinal grasps, ILM regrasping, time to ILM removal, and surgeon questionnaire comparing the use of micro-serrated and conventional ILM forceps. Results: A total of 90 eyes of 90 patients were included in the study. The mean number of deep retinal grasps was higher in the conventional forceps group (1.51 ± 1.70 versus 0.33 ± 0.56, respectively [p < 0.0001]). The mean number of failed ILM grasps was higher with conventional forceps (6.62 ± 3.51 versus 5.18 ± 2.06 [p = 0.019]). Micro-serrated forceps provided more comfortability (lower number) in initiating the ILM flap (2.16 ± 0.85 versus 1.56 ± 0.76, [p < 0.001]), comfortability in regrasping the ILM flap was (2.51 ± 1.01 versus 1.98 ± 0.89, p = 0.01), and comfortability in completing the ILM flap (2.42 ± 1.03 versus 1.84 ± 1.02, p = 0.01). Conclusion: Surgeons utilizing the micro-serrated forceps experienced fewer deep retina grasps and fewer failed ILM grasps using compared to conventional ILM forceps. The micro-serrated forceps was also a more favorable experience subjectively amongst the surgeons.