Removing ILM Prevents Macular Pucker Recurrence

May 12, 2010

As reported in OSN, a small study reports reduced recurrence of macular pucker when the ILM (internal limiting membrane) is safely removed.

The authors studied 65 eyes that underwent sutureless vitrectomy (25 or 23-gauge), no ICG dye staining and removal of the ILM.  The results showed an improvement of vision in 25% of patients.  The improvement in vision was both stable and statistically significant.

What Does This Mean?  The authors note that while there is visual improvement, the amount of improvement is limited.  They conclude that earlier vitrectomy is warranted to “save” further vision loss.

I agree that patients should consider vitrectomy as soon as they are aware of some non-correctable vision change due to macular pucker.  This can be either distortion and/or decreased vision.  In other words, a patient may be 20/20, but complaining of distortion.  Either can be a reason for operating.

The techniques have improved that given proper surgical technique, vision loss from this common macular disorder.

Randall V. Wong, M.D.

Retina Specialist
Fairfax, Virginia




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