title: Ultrastructural changes of the vitreoretinal interface during long-term follow-up after removal of the internal limiting membrane.
abstract: OBJECTIVE
  To investigate long-term ultrastructural changes in the retina after internal limiting membrane (ILM) peeling through the examination of morphologic changes 3 years after vitrectomy in cynomolgus monkeys.
  
  
  METHODS
  Laboratory investigation.
  
  
  METHODS
  Pars plana vitrectomy was performed, followed by ILM peeling, in 2 primate eyes. Ultrastructural changes were investigated using light microscopy and transmission and scanning electron microscopy 3 years after ILM peeling.
  
  
  RESULTS
  The remaining posterior vitreous and ILM-peeled areas were clearly recognized after the long-term follow-up. The exposed Müller cell processes were partially damaged, while regenerative spindle-shaped Müller cell processes developed, covering most of the retina. Notably, the nerve fiber layer was found to be uncovered and exposed to the vitreous space owing to misdirection of glial wound healing in some parts. In these areas, glial wound healing occurred beneath the nerve fiber layer. Although the glial cells covered the damaged areas, there was no apparent ILM regeneration in the shape of a continuous flat sheet, with the exception of accumulated deposits of basement membrane materials.
  
  
  CONCLUSIONS
  Although the retinal structures were well preserved after ILM peeling, ILM peeling resulted in mild damage to the vitreoretinal interface, which was not completely restored even after 3 years. The multilinear shape of the exposed nerve fiber may explain the previously reported dissociated optic nerve fiber layer appearance. The glial cells produced basement membrane materials around their processes, although they did not restore the ILM as a flat sheet.
authors.affiliation: Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Clinical Research Institute, Kyushu Medical Centre, Fukuoka, Japan. Electronic address: hisatomi@med.kyushu-u.ac.jp.
authors.forename: Toshio
authors.initials: T
authors.lastname: Hisatomi
authors.affiliation: Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Clinical Research Institute, Kyushu Medical Centre, Fukuoka, Japan.
authors.forename: Shoji
authors.initials: S
authors.lastname: Notomi
authors.affiliation: Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Tachibana
authors.affiliation: Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Yukio
authors.initials: Y
authors.lastname: Sassa
authors.affiliation: Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Ikeda
authors.affiliation: Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Takao
authors.initials: T
authors.lastname: Nakamura
authors.affiliation: Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Akifumi
authors.initials: A
authors.lastname: Ueno
authors.affiliation: Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Enaida
authors.affiliation: Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Toshinori
authors.initials: T
authors.lastname: Murata
authors.affiliation: Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Department of Ophthalmology, Kagoshima University School of Medicine, Kagoshima, Japan.
authors.forename: Taiji
authors.initials: T
authors.lastname: Sakamoto
authors.affiliation: Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Tatsuro
authors.initials: T
authors.lastname: Ishibashi
mesh_terms: D000818:Animals; D004195:Disease Models, Animal; D019773:Epiretinal Membrane / Q000473:pathology / Q000601:surgery*; D005500:Follow-Up Studies; D008252:Macaca fascicularis; D008855:Microscopy, Electron, Scanning; D017348:Microscopy, Electron, Scanning Transmission; D011184:Postoperative Period; D012160:Retina / Q000648:ultrastructure*; D013997:Time Factors; D041623:Tomography, Optical Coherence; D014821:Vitrectomy; D014822:Vitreous Body / Q000648:ultrastructure*