In a short study recently reported in Ophthalmology ^[1], researchers compared two groups of patient all undergoing epimacular membrane peeling. They note that the recurrence rate was lowest when the ILM was removed completely.

In the study involving 246 eyes, one group had the epiretinal membrane (ERM) only removed using indocyanine dye (ICG) and the second group had the ERM removed assisted with either nothing, triamcinolone acetonide or brilliant blue G. This second group then had the internal limiting membrane (ILM) removed using brilliant blue G.

Results were as follows;

1. No recurrence was seen in the group that underwent ERM removal followed by removal of any residual ILM as stained with brilliant blue G.

2.  Brilliant blue assisted ERM peeling also removed most of the ILM.  TA assisted ERM peeling was second and unassisted (no stain) ERM peeling left the most residual ILM

3.  The study authors feel that remaining ILM, after ERM surgery, may serve as a scaffold for recurrence.   They based their comments on histopathologic findings.

What does this mean? This small study indicates that removal of the ILM is an important key to preventing recurrence of epiretinal membranes.  It does not, however, answer the question as to whether ICG is better that brilliant blue G.  Does anyone have a comment?

Randall V. Wong, M.D.
Retina Specialist
www.RetinaEyeDoctor.com ^[2]