title: Macular pucker: to peel or not to peel the internal limiting membrane? A microperimetric response.
abstract: 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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: *Scientific Institute of Admission and Care, "G. B. Bietti" Foundation, IRCCS, Rome, Italy; Departments of †Endocrinology and Metabolism, ‡Energy and Systems Engineering, and §Surgical, Medical and Molecular Pathology, and Critical Area, University of Pisa, Pisa, Italy; ¶Department of Ophthalmology, Ospedale San Giovanni Addolorata, Rome, Italy; and **Department of Ophthalmology, University "Campus Bio-Medico," Rome, Italy.
authors.forename: Guido
authors.initials: G
authors.lastname: Ripandelli
authors.forename: Fabio
authors.initials: F
authors.lastname: Scarinci
authors.forename: Paolo
authors.initials: P
authors.lastname: Piaggi
authors.forename: Gianluca
authors.initials: G
authors.lastname: Guidi
authors.forename: Marco
authors.initials: M
authors.lastname: Pileri
authors.forename: Gaetano
authors.initials: G
authors.lastname: Cupo
authors.forename: Maria S
authors.initials: MS
authors.lastname: Sartini
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Parisi
authors.forename: Sara
authors.initials: S
authors.lastname: Baldanzellu
authors.forename: Cristiano
authors.initials: C
authors.lastname: Giusti
authors.forename: Marco
authors.initials: M
authors.lastname: Nardi
authors.forename: Mario
authors.initials: M
authors.lastname: Stirpe
authors.forename: Stefano
authors.initials: S
authors.lastname: Lazzeri
mesh_terms: D000368:Aged; D001485:Basement Membrane / Q000601:surgery*; D019773:Epiretinal Membrane / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012160:Retina / Q000502:physiology*; D012607:Scotoma / Q000503:physiopathology; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology*; D058609:Visual Field Tests; D014794:Visual Fields / Q000502:physiology*; D014821:Vitrectomy