Influence of internal limiting membrane peeling during idiopathic epiretinal membrane removal: a randomized controlled trial
Abstract In epiretinal membrane (ERM) surgery, the influence of internal limiting membrane (ILM) integrity after ERM removal is underexplored. This study investigated outcomes of idiopathic ERM surgery based on ILM condition following ERM removal and intentional peeling of residual ILM. In this pros...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2025-05-01
|
| Series: | Scientific Reports |
| Subjects: | |
| Online Access: | https://doi.org/10.1038/s41598-025-01987-z |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850140639837028352 |
|---|---|
| author | Bo Hee Kim Chang Ki Yoon Kunho Bae Eun Kyoung Lee Chan Ho Lee Dong Ik Kim Ki Woong Bae Un Chul Park |
| author_facet | Bo Hee Kim Chang Ki Yoon Kunho Bae Eun Kyoung Lee Chan Ho Lee Dong Ik Kim Ki Woong Bae Un Chul Park |
| author_sort | Bo Hee Kim |
| collection | DOAJ |
| description | Abstract In epiretinal membrane (ERM) surgery, the influence of internal limiting membrane (ILM) integrity after ERM removal is underexplored. This study investigated outcomes of idiopathic ERM surgery based on ILM condition following ERM removal and intentional peeling of residual ILM. In this prospective, randomized clinical trial, 102 patients underwent vitrectomy for idiopathic ERM. After ERM removal, ILM status was evaluated using indocyanine green staining. Patients with mostly removed ILM were allocated to group 1 (involuntary peeling), whereas those with partially removed or intact ILM were randomized 1:1 to active peeling (group 2) or non-peeling of residual ILM (group 3). Recurrence of ERM during 12-month follow-up occurred only in group 3 (36.1%), particularly when residual ILM involved the fovea. Best-corrected visual acuity, metamorphopsia, and aniseikonia did not differ among groups; however, group 3 showed significantly lower central macular thickness at all follow-ups (p < 0.05) and better macular contour restoration according to retinal thickness profiles. In patients whose residual ILM involved the fovea, non-peeling resulted in less severe vertical metamorphopsia when ERM did not recur. These findings suggest that residual ILM peeling decisions during ERM surgery should consider both anatomical and functional outcomes, as non-peeling favoring anatomical macular recovery but increasing recurrence risk. |
| format | Article |
| id | doaj-art-ba0cebdc143c4a848b0c400ccdba9082 |
| institution | OA Journals |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj-art-ba0cebdc143c4a848b0c400ccdba90822025-08-20T02:29:45ZengNature PortfolioScientific Reports2045-23222025-05-0115111110.1038/s41598-025-01987-zInfluence of internal limiting membrane peeling during idiopathic epiretinal membrane removal: a randomized controlled trialBo Hee Kim0Chang Ki Yoon1Kunho Bae2Eun Kyoung Lee3Chan Ho Lee4Dong Ik Kim5Ki Woong Bae6Un Chul Park7Department of Ophthalmology, Seoul National University College of MedicineDepartment of Ophthalmology, Seoul National University College of MedicineDepartment of Ophthalmology, Seoul National University College of MedicineDepartment of Ophthalmology, Seoul National University College of MedicineDepartment of Ophthalmology, Seoul National University College of MedicineDepartment of Ophthalmology, Seoul National University College of MedicineDepartment of Ophthalmology, Seoul National University College of MedicineDepartment of Ophthalmology, Seoul National University College of MedicineAbstract In epiretinal membrane (ERM) surgery, the influence of internal limiting membrane (ILM) integrity after ERM removal is underexplored. This study investigated outcomes of idiopathic ERM surgery based on ILM condition following ERM removal and intentional peeling of residual ILM. In this prospective, randomized clinical trial, 102 patients underwent vitrectomy for idiopathic ERM. After ERM removal, ILM status was evaluated using indocyanine green staining. Patients with mostly removed ILM were allocated to group 1 (involuntary peeling), whereas those with partially removed or intact ILM were randomized 1:1 to active peeling (group 2) or non-peeling of residual ILM (group 3). Recurrence of ERM during 12-month follow-up occurred only in group 3 (36.1%), particularly when residual ILM involved the fovea. Best-corrected visual acuity, metamorphopsia, and aniseikonia did not differ among groups; however, group 3 showed significantly lower central macular thickness at all follow-ups (p < 0.05) and better macular contour restoration according to retinal thickness profiles. In patients whose residual ILM involved the fovea, non-peeling resulted in less severe vertical metamorphopsia when ERM did not recur. These findings suggest that residual ILM peeling decisions during ERM surgery should consider both anatomical and functional outcomes, as non-peeling favoring anatomical macular recovery but increasing recurrence risk.https://doi.org/10.1038/s41598-025-01987-zInternal limiting membraneEpiretinal membraneRecurrenceMetamorphopsia |
| spellingShingle | Bo Hee Kim Chang Ki Yoon Kunho Bae Eun Kyoung Lee Chan Ho Lee Dong Ik Kim Ki Woong Bae Un Chul Park Influence of internal limiting membrane peeling during idiopathic epiretinal membrane removal: a randomized controlled trial Scientific Reports Internal limiting membrane Epiretinal membrane Recurrence Metamorphopsia |
| title | Influence of internal limiting membrane peeling during idiopathic epiretinal membrane removal: a randomized controlled trial |
| title_full | Influence of internal limiting membrane peeling during idiopathic epiretinal membrane removal: a randomized controlled trial |
| title_fullStr | Influence of internal limiting membrane peeling during idiopathic epiretinal membrane removal: a randomized controlled trial |
| title_full_unstemmed | Influence of internal limiting membrane peeling during idiopathic epiretinal membrane removal: a randomized controlled trial |
| title_short | Influence of internal limiting membrane peeling during idiopathic epiretinal membrane removal: a randomized controlled trial |
| title_sort | influence of internal limiting membrane peeling during idiopathic epiretinal membrane removal a randomized controlled trial |
| topic | Internal limiting membrane Epiretinal membrane Recurrence Metamorphopsia |
| url | https://doi.org/10.1038/s41598-025-01987-z |
| work_keys_str_mv | AT boheekim influenceofinternallimitingmembranepeelingduringidiopathicepiretinalmembraneremovalarandomizedcontrolledtrial AT changkiyoon influenceofinternallimitingmembranepeelingduringidiopathicepiretinalmembraneremovalarandomizedcontrolledtrial AT kunhobae influenceofinternallimitingmembranepeelingduringidiopathicepiretinalmembraneremovalarandomizedcontrolledtrial AT eunkyounglee influenceofinternallimitingmembranepeelingduringidiopathicepiretinalmembraneremovalarandomizedcontrolledtrial AT chanholee influenceofinternallimitingmembranepeelingduringidiopathicepiretinalmembraneremovalarandomizedcontrolledtrial AT dongikkim influenceofinternallimitingmembranepeelingduringidiopathicepiretinalmembraneremovalarandomizedcontrolledtrial AT kiwoongbae influenceofinternallimitingmembranepeelingduringidiopathicepiretinalmembraneremovalarandomizedcontrolledtrial AT unchulpark influenceofinternallimitingmembranepeelingduringidiopathicepiretinalmembraneremovalarandomizedcontrolledtrial |