Effects of internal limiting membrane peeling versus non-internal limiting membrane peeling during vitrectomy for diabetic tractional retinal detachment on postoperative macular thickness, foveal contour, and formation of epiretinal membranes

Abstract

Aim To investigate the impact of internal limiting membrane (ILM) peeling during vitrectomy for diabetic tractional retinal detachment (TRD) on postoperative central macular thickness, foveal contour, and creation or reformation of epiretinal membranes. Methods In a randomized trial, patients aged 40–65 years old with TRD were recruited from the outpatient clinic in Suez Canal University Hospital from August 2020 to February 2022. Patients were randomized into two groups: group 1 did vitrectomy with ILM peeling, while group 2 did vitrectomy without ILM peeling. At 1, 3, and 6 months after surgery, optical coherence tomography (OCT) was carried out to investigate the central macular thickness (CMT), foveal contour, and epiretinal membrane’s presence. For categorical variables, the Chi-squared test or Fisher’s exact test was performed, while the Student’s t-test was used to assess differences in continuous data. Results Thirty-two patients (16 in each group) completed the required follow-up. There was no significant difference between both groups concerning the affected eye (P=1.00). There was no statistically significant difference regarding the CMT recorded via optical coherence tomography at any point of follow-up in the two groups (P=0.289). Also, there was no statistically significant difference regarding the presence of foveal depression at any point of follow-up in the two groups (P=0.680). On the other hand, the percentage of patients who showed no presence of epiretinal membranes in the ILM peeling group was statistically significant when compared with the non-ILM peeling group (P<0.001). Conclusions ILM peeling decreases the incidence of epiretinal membrane proliferation following diabetic vitrectomy.