Macular pucker: To peel or not to peel the internal limiting membrane? a microperimetric response

Guido Ripandelli, Fabio Scarinci, Paolo Piaggi, Gianluca Guidi, Marco Pileri, Gaetano Cupo, Maria S. Sartini, Vincenzo Parisi, Sara Baldanzellu, Cristiano Giusti, Marco Nardi, Mario Stirpe, Stefano Lazzeri

Research output: Contribution to journalArticlepeer-review


Background: To compare functional and anatomical outcomes after idiopathic macular pucker removal between eyes that underwent internal limiting membrane (ILM) peeling and eyes that did not. Methods: In this multicentric, randomized clinical trial, 60 eyes of 60 patients affected with idiopathic macular pucker were enrolled. Thirty eyes underwent 23-gauge pars plana vitrectomy associated with ILM peeling ("ILM peeling group"), whereas 30 eyes did not undergo ILM peeling ("ILM not peeling group"). Retinal sensitivity, frequency of microscotomas, and all the other microperimetric parameters were tested by MP1 microperimetry. Best-corrected visual acuity was investigated with the Early Treatment Diabetic Retinopathy Study chart. Anatomical outcomes were analyzed with spectral domain optical coherence tomography. Results: After a 12-month follow-up, the mean retinal sensitivity in the 4° central area showed a greater and faster recovery in the ILM not peeling group than in the ILM peeling group (P =0.041). The number of absolute microscotomas (0 dB) within the 12° central retinal area was significantly higher in the ILM peeling group than in the ILM not peeling group (P =0.044). Conclusion: The ILM not peeling group seems to show better outcomes than the ILM peeling group as measured by mean retinal sensitivity and number of microscotomas after a 12-month follow-up.

Original languageEnglish
Pages (from-to)498-507
Number of pages10
Issue number3
Publication statusPublished - Mar 10 2015


  • ERM removal
  • ILM peeling
  • microperimetry
  • microscotomas
  • retinal sensitivity

ASJC Scopus subject areas

  • Ophthalmology
  • Medicine(all)


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