Comparison Between Scleral Buckling and Vitrectomy in the Onset of Cystoid Macular Edema and Epiretinal Membrane After Rhegmatogenous Retinal Detachment Repair

Gharbiya, Magda; Visioli, Giacomo; Iannetti, Ludovico; Iannaccone, Andrea; Tamburrelli, Anna Clara; Marenco, Marco; Albanese, Giuseppe Maria

doi:10.1097/iae.0000000000003475

Cited by 13 publications

(6 citation statements)

References 33 publications

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“…The current study finds that postoperative ERM after PPV or combined PPV/SB for GRT-RD repair is 70.6%, a significantly higher incidence when compared to a routine RRD repair with a reported incidence of 12.1% to 30.8%. 14,15,17,18,20 One study has shown that the incidence of ERM after PPV for a routine RRD could be as high as 70.3% using en face OCT, 21 likely due to its high sensitivity, whereas the current and most of the other studies 14,15,17,18,20 have analyzed spectral-domain OCT for presence of ERM. Studies have suggested that epiretinal proliferation has multiple etiologies including RPE cell migration through a full-thickness retinal break, retinal glial cells as well as vitreous components including platelet-derived growth factors, cytokines and blood cells.…”

Section: Discussionmentioning

confidence: 99%

Incidence of Epiretinal Membrane Formation After Pars Plana Vitrectomy for Giant Retinal Tear-Associated Retinal Detachment

Lee¹,

Benjamin²,

Ghorayeb³

2023

OPTH

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Objective To report the incidence of postoperative epiretinal membrane (ERM) formation after primary pars plana vitrectomy (PPV) for giant retinal tear associated retinal detachment (GRT-RD) repair as well as its clinical characteristics and visual outcomes at a level one trauma and tertiary referral academic center. Patients and Methods Patients with primary RD repair for GRT-RD at West Virginia University from September 2010 to July 2021 were identified using the ICD-10 codes (H33.031, H33.032, H33.033 and H33.039). Imaging studies including optical coherence tomography (OCT) were manually reviewed pre- and post-operatively for ERM formation after PPV for GRT-RD repair in patients who underwent PPV or combined PPV and scleral buckle (SB). Univariate analysis was performed to analyze clinical factors for ERM formation. Results The study included 17 eyes of 16 patients who underwent PPV for GRT-RD. Postoperative ERM was observed in 70.6% (13 of 17 eyes) of the patients. Anatomic success was achieved in all patients. The mean (range) preoperative and final best corrected visual acuity (BCVA) in logMAR units by macula status was 0.19 (0–0.5) and 0.28 (0–0.5) for macula-on and 1.7 (0.5–2.3) and 0.7 (0.2–1.9) for macular-off GRT-RDs. Clinical variables including use of medium-term tamponade with perfluorocarbon liquid (PFCL), cryopexy, endodiathermy, number of tears or total clock hours of tears did not correlate with an increased risk of ERM formation. Conclusion Post-vitrectomized eyes for GRT-RD repair have a significantly higher incidence of ERM formation, nearing 70% in our study. Surgeons may consider prophylactic ILM peel at the time of removal of tamponade agents or weigh in ILM peel at the time of primary repair, a more challenging surgical technique in our opinion.

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Section: Discussionmentioning

confidence: 99%

Incidence of Epiretinal Membrane Formation After Pars Plana Vitrectomy for Giant Retinal Tear-Associated Retinal Detachment

Lee¹,

Benjamin²,

Ghorayeb³

2023

OPTH

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“…Similarly, considering all 12 eyes of our study, no post-operative macular OCT has shown the onset of cystoid macular edema (CME), which represents a common complication in standard PPV. In fact, recent studies have highlighted that the incidence of CME after rhegmatogenous retinal detachment repair was higher in patients who underwent PPV, either alone or combined with phacoemulsification than in those treated with SB [ 29 ]. Probably, the use of cryotherapy retinopexy instead of endolaser retinopexy [ 30 ] plays a role in lowering the risk of post-operative CME.…”

Section: Discussionmentioning

confidence: 99%

Two-Port “Dry Vitrectomy” as a New Surgical Technique for Rhegmatogenous Retinal Detachment: Focus on Macula-on Results

et al. 2023

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We evaluated a new surgical technique for treating primary rhegmatogenous retinal detachment (RRD), consisting of localized vitrectomy near the retinal break associated with drainage of subretinal fluid without infusion. Twelve eyes of twelve patients with primary RRDs with macula-on superior, temporal, and/or nasal quadrants’ RRD with retinal breaks between 8 and 4 o’clock, pseudophakic or phakic eyes, were enrolled. All eyes underwent a two-port 25-gauge vitrectomy with localized removal of the vitreous surrounding the retinal break(s), followed by a 20% SF6 injection and cryopexy. The difference between pre-operative (T0) and post-operative mean BCVA at 6 months follow-up (T6) was not statistically significant (0.16 logMAR vs. 0.21 logMAR; p = 0.055). Primary anatomic success at 6 months was achieved by 86% of patients. No other complications, except for two retinal re-detachments linked to an incorrect head position of the patients, were recorded. Although further studies are necessary to evaluate the treatment’s efficacy, we believe our technique could be considered a valid alternative for managing primary RRD.

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“…Finally, a substantial proportion (15.8%) of our patients had undergone SB. Gharbiya et al [19] showed that PSME was more common after vitrectomy (26.0%), either alone or combined with CS, than after SB (5.3%). Lai et al [21] found that the risk factors associated with PSME after SB were older age, more extended RRD, macular detachment, and external drainage.…”

Section: Discussionmentioning

confidence: 99%

Macular oedema secondary to rhegmatogenous retinal detachment repair: risk factors for resistance to first-line therapy and long-term response to dexamethasone intravitreal implant

Souissi,

Allou,

Trucchi

et al. 2023

Eye

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Objectives: To assess the risk factors for recalcitrance to rst-line therapy and the long-term response to dexamethasone intravitreal implant (Ozurdex ® ) of postsurgical macular edema (PSME) after rhegmatogenous retinal detachment (RRD).Methods: This was a retrospective consecutive cohort study of patients who underwent RRD repair between January 2014 and December 2020 at the Rothschild Foundation Hospital and who experienced PSME with at least 18 months of follow-up.Results: Of the 1 152 patients screened, 36 eyes had a PSME (incidence: 3.1%). The mean follow-up was 45.2 months (18.0-80.5 months). Twenty-ve eyes (69.4%) were recalcitrant to rst-line therapy and received at least one Ozurdex ® (mean number: 2.7 [1-12]). On multivariate analysis, per uorocarbon liquid (PFCL)-assisted drainage was found to signi cantly increase the risk of recalcitrance (adjusted odds ratio 8.65; 95% con dence interval 1.97-15.33; p = 0.01). A signi cant difference in best-corrected visual acuity (BCVA) and central macular thickness (CMT) was found before Ozurdex® and at the last follow-up visit: 0.57 ± 0.47 LogMAR vs. 0.34 ± 0.32 LogMAR (p = 0.02) and 483.0 ± 124.0 µm to 354.6 ± 96.5 µm (p=0.001). The absence of serous retinal detachment and the presence of hyperre ective foci at baseline were negative prognostic factors both for recalcitrance and for response to Ozurdex®. Two patients (8%) experienced hypertony, which was well controlled with hypotonic drops. Conclusion: PSME after RRD is highly recalcitrant. Ozurdex® could be reasonably proposed as a rst-line treatment, at least if it occurs after PFLC-assisted drainage, given the favorable bene t/risk ratio in the long term.

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Comparison Between Scleral Buckling and Vitrectomy in the Onset of Cystoid Macular Edema and Epiretinal Membrane After Rhegmatogenous Retinal Detachment Repair

Cited by 13 publications

References 33 publications

Incidence of Epiretinal Membrane Formation After Pars Plana Vitrectomy for Giant Retinal Tear-Associated Retinal Detachment

Incidence of Epiretinal Membrane Formation After Pars Plana Vitrectomy for Giant Retinal Tear-Associated Retinal Detachment

Two-Port “Dry Vitrectomy” as a New Surgical Technique for Rhegmatogenous Retinal Detachment: Focus on Macula-on Results

Macular oedema secondary to rhegmatogenous retinal detachment repair: risk factors for resistance to first-line therapy and long-term response to dexamethasone intravitreal implant

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