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Purpose: This study was designed to evaluate the effect of internal limiting membrane (ILM) peeling in the surgical management of idiopathic macular epiretinal membrane (ERM). Method: The records of 36 patients (36 eyes) with idiopathic macular ERM who had undergone pars plana vitrectomy with removal of the ERM were retrospectively reviewed. The patients were divided into two groups: eyes with (18 eyes) or without (18 eyes) ILM peeling. The best corrected visual acuity (BCVA), recurrence of ERM, persistence of retinal wrinkling, as well as the complications and improvement of visual acuity of the two groups were compared. Results: The mean pre-operative BCVA for the two groups was 0.29 in the group with ILM peeling and 0.26 in the group without ILM peeling, while the mean post-operative BCVA was 0.59 and 0.50, respectively. Although the post-operative BCVA significantly improved in both groups (P=0.001), there was no statistically significant difference between the two groups (P>0.05). However, the persistence of retinal wrinkling greatly decreased in the group with ILM peeling, and ERM recurred in two cases in the group without ILM peeling. Conclusion: ILM peeling in the surgical management of idiopathic macular ERM does not affect the postoperative results of visual acuity and complications, except for the persistence of retinal wrinkling and recurrence.

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