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Purpose   To compare changes in the retinal layer thickness and visual outcomes in patients undergoing epiretinal membrane (ERM) surgery with or without internal limiting membrane (ILM) peeling.Methods   Seventy-six eyes of 76 patients who underwent ERM surgery from January 2013 to March 2015 at the Department of Ophthalmology, Yonsei University College of Medicine, Seoul, South Korea, were analyzed. While ERM removal with ILM peeling was performed in ILM peeling (P) group ( n =39), ILM peeling was not performed in non-ILM peeling (NP) group ( n =37). Retinal layer segmentation was performed using optical coherence tomography images. Individual retinal layer thicknesses before and at 6 months after ERM surgery were compared. The postoperative best-corrected visual acuity (BCVA) was also compared.Results   In the P group, the thicknesses of retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), and inner plexiform layer (IPL) were significantly reduced. In the NP group, significant decreases in the RNFL, GCL, IPL, inner nuclear layer, and outer plexiform layer were observed. The P group manifested a greater mean postoperative GCL (35.56 ± 1.53  µ m vs 29.86 ± 2.16  µ m;  p =0.033) and less loss of GCL (−10.26 ± 1.91  µ m vs −19.86 ± 2.74  µ m;  p =0.004) compared to the NP group. No statistically significant differences were observed when comparing the changes in BCVA.Conclusions   This study demonstrates that ILM peeling for ERM surgery may result in better preservation of GCL compared to no ILM peeling.

Comparison of Individual Retinal Layer Thicknesses after Epiretinal Membrane Surgery with or without Internal Limiting Membrane Peeling