title: Double peeling during vitrectomy for macular pucker: the Charles L. Schepens Lecture.
abstract: Epiretinal membranes are commonly encountered in retinal practice, and they result in decreased vision. The present work addresses whether peeling of the internal limiting membrane is necessary during vitrectomy for macular pucker. We performed a retrospective analysis to investigate the effects of "single peeling," in which only the epiretinal membrane was peeled, and "double peeling," in which the internal limiting membrane was also stained and peeled. Although significantly more patients in the single-peeling group had an epiretinal membrane remaining in the central fovea postoperatively, visual acuity was not found to differ between the 2 groups in the short term. Patients who had an epiretinal membrane for more than 18 months had significantly worse visual acuity outcomes. Unexpectedly, there was a greater proportional decrease in central macular thickness in the single-peeling group than in the double peeling group, a finding that deserves further study.
authors.affiliation: Edward S. Harkness Eye Institute, Columbia University College of Physicians and Surgeons, New York, NY, USA. sc434@columbia.edu
authors.forename: Stanley
authors.initials: S
authors.lastname: Chang
authors.forename: Emily M
authors.initials: EM
authors.lastname: Gregory-Roberts
authors.forename: Sungpyo
authors.initials: S
authors.lastname: Park
authors.forename: Ketan
authors.initials: K
authors.lastname: Laud
authors.forename: Scott D
authors.initials: SD
authors.lastname: Smith
authors.forename: Quan V
authors.initials: QV
authors.lastname: Hoang
mesh_terms: D000368:Aged; D001485:Basement Membrane / Q000473:pathology / Q000601:surgery*; D004396:Coloring Agents; D019773:Epiretinal Membrane / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D014222:Triamcinolone Acetonide; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy
chemical_list: D004396:Coloring Agents; D014222:Triamcinolone Acetonide