2022/06/02 by Deepti Pradhan, Lalit P. Agarwal, Pradhan, Deepti +9
Biochemistry, Genetics and Molecular Biology · Medicine · #DONFL #Medicine and health #Ocriplasmin #Retinal Development and Disorders #Retinal Diseases and Treatments #Retinal and Macular Surgery #Vitalfarbstofffärbung #adverse effects of ILM peeling #temporal ILM flap #temporärer ILM Flap #unerwünschte Wirkungen des ILM-Peelings #vital dye staining
paper · doi:10.3205/000309
openalex publication_date 2022/06/02 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/19
Since the era when macular hole was considered untreatable, macular hole surgery has come a long way to being one of the most successful surgeries. Internal limiting membrane (ILM) peeling has been an essential step of macular hole surgery since the establishment of the role of ILM in the aetiopathogenesis and progression of macular hole. However, the novel technique was not all virtuous. It had some vices which were not evident immediately. With the advent of spectral domain optical coherence tomography, short- and long-term effects of ILM peeling on macular structures were known; and with microperimetry, its effect on the function of macula could be evaluated. The technique has evolved with time from total peeling to inverted flap to just temporal peeling and temporal flap in an attempt to mitigate its adverse effects and to improve its surgical outcome. ILM abrasion technique and Ocriplasmin may eliminate the need of ILM peeling in selected cases, but they have their own limitations. We here discuss the role of ILM in the pathogenesis of macular hole, the benefits and adverse effects of ILM peeling, and the various modifications of the procedure, to then explore the alternatives.