Effect of Internal Limiting Membrane Peeling on the Development of Epiretinal Membrane After Pars Plana Vitrectomy for Primary Rhegmatogenous Retinal Detachment

Nam, Ki Yup; Kim, Jung‐Yeul

doi:10.1097/iae.0000000000000421

Cited by 68 publications

(76 citation statements)

References 18 publications

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“…This is a lower percentage than the 3.6–12.8% reported by others [ 32 , 33 ]. The most likely explanation for the development of ERM is that the retinal pigment epithelial cells migrate to the surface of the posterior pole of the retina by diffusing into the vitreous cavity through the break or through fibrosis [ 33 ]. In our modified technique, the remaining vitreous probably prevented such diffusion into the vitreous cavity.…”

Section: Discussioncontrasting

confidence: 65%

Modified Vitrectomy Technique for Phakic Rhegmatogenous Retinal Detachment with Intermediate Break

Bonfiglio

Toro

Longo

et al. 2018

Journal of Ophthalmology

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Purpose To evaluate the effects of a modification of the traditional 25-gauge pars plana vitrectomy technique in the treatment of uncomplicated macula-on rhegmatogenous retinal detachment (RRD) with intermediate retinal break(s) and marked vitreous traction in the phakic eye. Methods Prospective, noncomparative, and interventional case series. All consecutive phakic eyes with primary uncomplicated macula-on RRD with intermediate retinal break(s) and marked vitreous traction, with at least 1 year of postoperative follow-up, were enrolled. In all eyes, “localized 25-gauge vitrectomy” under air infusion with localized removal of the vitreous surrounding the retinal break(s), in association with laser photocoagulation and air tamponade, was performed. The primary end point was the rate of primary retinal attachment. Secondary end points were cataract progression and assessed by digital Scheimpflug lens photography (mean change of nuclear density units) and the rate of complications. Results Thirty-two phakic eyes were included in the final analysis. At 12 months, the primary outcome of anatomical success was achieved in 94% of eyes. The mean nuclear density units did not change significantly at any time point during the follow-up. After localized vitrectomy, one eye developed an epiretinal membrane, and one eye developed cystoid macular edema; no other significant complications were reported. Conclusions “Localized vitrectomy” has a high anatomical success rate in phakic eyes with primary uncomplicated macula-on RRD with intermediate retinal break(s) and marked vitreous traction, without causing progression of cataract.

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Section: Discussioncontrasting

confidence: 65%

Modified Vitrectomy Technique for Phakic Rhegmatogenous Retinal Detachment with Intermediate Break

Bonfiglio

Toro

Longo

et al. 2018

Journal of Ophthalmology

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“…Nam and Kim [ 12 ] reported that postoperative ERM tended to occur within 3 months of the vitrectomy for rRD, with the interval (within 3 months) clearly shorter than the interval from the initial vitrectomy to the MH formation in our current study. Thus, it is possible that the MHs might have been developed after continuous traction caused by the ERMs.…”

Section: Discussioncontrasting

confidence: 43%

“…However, the interval in Case 2 was not all that much shorter than that observed in Cases 1 and 4. In an ERM that occurs after rRD, the retinal pigment epithelial cells migrate to the vitreous cavity through the retinal break and settle on the macular surface, forming the membrane [ 12 ]. As with an equatorial break, an intentional hole might shorten the interval, because of the presence at the posterior vitreous cavity.…”

Section: Discussionmentioning

confidence: 99%

Full-Thickness Macular Hole Formation in the Postoperative Period After Initial Vitrectomy for Rhegmatogenous Retinal Detachment

Takashina

Watanabe

Tsuneoka

2017

Case Rep Ophthalmol

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Background and Objective: To evaluate full-thickness macular hole (MH) formation in the postoperative period after initial vitrectomy for rhegmatogenous retinal detachment (rRD). Materials and Methods: We retrospectively reviewed the medical records of 4 consecutive eyes that required additional vitrectomy for full-thickness MH between April 2013 and March 2016 after undergoing an initial vitrectomy for rRD. Results: Epiretinal membrane (ERM) was identified by preoperative optical coherence tomography or intraoperative dye staining in each case. Photocoagulation of retinal breaks prior to initial vitrectomy was performed in Cases 1, 2, and 3 (4–16 days), with yttrium-aluminum-garnet capsulotomy after cataract extraction also performed prior to the retinal break formation in Case 3. At the initial vitrectomy, there was a superior retinal break which crossed the equator in Case 2, and an intentional hole was created in Cases 1 and 4. The mean interval from the initial vitrectomy until MH formation was 27.5 ± 15.8 months. As with Case 2, the intervals in Cases 1 and 4, in which an intentional hole was created, were clearly shorter than in those in Case 3. Finally, MH closure was achieved after an additional vitrectomy (removal of the internal limiting membrane with ERM and gas tamponade) and best-corrected visual acuity improved in each case. Conclusion: ERM was identified in the cases examined in our study. The presence of an intentional hole might shorten the interval of MH formation after vitrectomy for rRD.

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“…Another theory attributes the pathogenesis of an ERM to the growth and fibrous metaplasia of the vitreous cells that remain on the retina surface after posterior vitreous detachment. On the other hand, in the ERM that occur after rhegmatogenous RD, the retinal pigment epithelial cells are thought to migrate to the vitreous cavity through the retinal break and settle on the retinal surface, forming the membrane [ 26 ]. None of these theories put forth a reason behind certain patients developing PVR rapidly while others—not at all.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of TGF-Beta 2 and VEGFα Gene Expression Levels in Epiretinal Membranes and Internal Limiting Membranes in the Course of Retinal Detachments, Proliferative Diabetic Retinopathy, Macular Holes, and Idiopathic Epiretinal Membranes

Stafiej

Kaźmierczak

Linkowska

et al. 2018

Journal of Ophthalmology

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Purpose To evaluate the expression profiles of the VEGFα and TGFβ in the ERMs and ILMs in retinal disorders. Methods In this nonrandomized prospective study, 75 patients (34 females and 41 males) referred to pars plana vitrectomy (PPV) due to different retinal diseases were enrolled to the study. The samples of ERMs and ILMs collected during PPV were immediately put in TRIzol® Reagent (Life Technologies, USA) and stored at −70°C until RNA extraction. Gene expression analysis was done with TaqMan® Gene Expression Assays (Applied Biosystems, USA) following the manufacturer's instructions. Results The gene expression levels of VEGFα as well as of TGFβ2 were significantly higher in ERMs than in ILMs in all studied groups. The level of TGFβ2 expression exhibits a significantly lower values in iERMs as compared with the RRD group (p = 0.043). There were differences in TGFβ2 expression in ILM in groups studied: DR versus RRD, p = 0.003; DR versus iERM, p = 0,047; and iERM versus RRD, p = 0.004. Conclusions Our results revealed that factors associated with angiogenesis and wound healing processes in eyes with RRD, PDR, iERM, and MH were more upregulated in ERMs than in ILMs. This may indicate that ILM is not responsible for reproliferation and its peeling should be avoided in routine PPV.

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Effect of Internal Limiting Membrane Peeling on the Development of Epiretinal Membrane After Pars Plana Vitrectomy for Primary Rhegmatogenous Retinal Detachment

Abstract: Internal limiting membrane peeling seems to prevent the occurrence of a postoperative ERM in patients with primary rhegmatogenous retinal detachment.

Cited by 68 publications

References 18 publications

Modified Vitrectomy Technique for Phakic Rhegmatogenous Retinal Detachment with Intermediate Break

Modified Vitrectomy Technique for Phakic Rhegmatogenous Retinal Detachment with Intermediate Break

Full-Thickness Macular Hole Formation in the Postoperative Period After Initial Vitrectomy for Rhegmatogenous Retinal Detachment

Evaluation of TGF-Beta 2 and VEGFα Gene Expression Levels in Epiretinal Membranes and Internal Limiting Membranes in the Course of Retinal Detachments, Proliferative Diabetic Retinopathy, Macular Holes, and Idiopathic Epiretinal Membranes

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