Extensive internal limiting membrane peeling for proliferative vitreoretinopathy

• Published in: International ophthalmology Vol. 43; no. 1; pp. 147 - 153
• Main Authors: Francone, Anibal, Charles, Martín
• Format: Journal Article
• Language: English
• Published: Dordrecht Springer Netherlands 01-01-2023; Springer Nature B.V
• Subjects: Acuity; Basement Membrane - surgery; Constraining; Epiretinal Membrane - surgery; Eye; Eye (anatomy); Humans; Long-term effects; Medicine; Medicine & Public Health; Membranes; Ophthalmology; Original Paper; Peeling; Retina; Retinal detachment; Retinal Detachment - complications; Retinal Detachment - diagnosis; Retinal Detachment - surgery; Retrospective Studies; Silicones; Success; Tamponade; Visual acuity; Visualization; Vitrectomy - methods; Vitreoretinopathy, Proliferative - complications; Vitreoretinopathy, Proliferative - surgery; Internal limiting membrane peeling; Retinal detachment; 3D visualization system; Brilliant blue G; Proliferative vitreoretinopathy
• DOI: 10.1007/s10792-022-02397-0
• EISSN: 1573-2630
• ISSN: 1573-2630; 0165-5701

Purpose
The aim of this study was to describe the anatomical outcomes of Brilliant Blue G (BBG)–assisted extensive internal limiting membrane peeling for proliferative vitreoretinopathy (PVR) under three-dimensional (3D) visualization.
Methods
This study constitutes a retrospective case series conducted in a private retina practice, of 14 consecutive patients (14 eyes) with rhegmatogenous retinal detachment complicated by PVR who underwent pars plana vitrectomy between January 2019 and January 2020. The internal limiting membrane (ILM) was selectively stained with BBG, and perspectives were enhanced with a 3D visualization system. We peeled off the ILM beyond the vascular arcades up to the periphery. The main outcome was anatomical success, defined as persistent retinal reattachment after removal of the silicone oil tamponade.
Results
Anatomic success was achieved with a single surgery in 11 of 14 (78.6%) eyes, and eventual success was achieved in all eyes. The mean patient follow-up time was 12.3 months (range, 7–16 months). The mean preoperative best-corrected visual acuity (BCVA) was 2.93 ± 0.79 logMAR which improved to 1.75 + 0.91 at the last follow-up.
Conclusion
Extensive ILM peeling allowed the creation of a cleavage plane underlying the PVR membranes that facilitated its complete removal, thereby achieving anatomically reattached retina and reducing the risk of recurrence of retinal detachment. The long-term effects of this technique need further research.