MACULAR PUCKER To Peel or Not to Peel the Internal Limiting

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 microsco-tomas, and all the other microperimetric parameters were tested by MP1 microperimetry. Best-corrected visual acuity was investigated with the Early Treatment Diabetic Retinopa-thy Study chart. Anatomical outcomes were analyzed with spectral domain optical coher-ence 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 peelin