Efficacy of 27-Gauge Vitrectomy with Internal Limiting Membrane Peeling for Epiretinal Membrane in Glaucoma Patients

Yoshida, Masaaki; Kunikata, Hiroshi; Kunimatsu-Sanuki, Shiho; Nakazawa, Toru

doi:10.1155/2019/7807432

Cited by 10 publications

(10 citation statements)

References 32 publications

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“…The visual acuity and VF sensitivity of our patients were relatively poorer, with a mean (±SD) visual acuity (logMAR) and MD (dB) of 0.68 ± 0.30 and 210.19 ± 7.13, respectively, compared with 0.16 ± 0.16 and 28.4 ± 5.7 in Tsuchiya's study and 0.29 and 28.7 in Yoshida's study. 6,21 Interestingly, the group with preserved or improved visual acuity in our study had a mean MD of 26.64 ± 3.92, similar to the above studies. Figure 2 clearly shows that eyes with advanced VF defects more than 212 dB have a much higher risk of unfavorable visual outcomes after vitrectomy.…”

Section: Discussionsupporting

confidence: 89%

Factors Related to Unfavorable Visual Outcome After Idiopathic Epiretinal Membrane Surgery in Patients With Glaucoma

Chen

Huang

et al. 2022

Retina

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Purpose: To evaluate the visual outcomes after idiopathic epiretinal membrane surgery in glaucomatous and nonglaucomatous eyes and factors related to unfavorable outcomes in glaucomatous eyes.Methods: This was a retrospective cohort study including patients undergoing idiopathic epiretinal membrane surgery with $12-month follow-up. Final visual acuity at pseudophakic status was compared among groups of glaucoma, glaucoma suspect, and nonglaucoma and correlated with optical coherence tomography and visual field characteristics in patients with glaucoma.Results: Of the 314 patients enrolled, 31 had glaucoma and 22 were glaucoma suspect. Baseline visual acuity and central foveal thickness were similar across the groups. Most patients had improved/stable visual acuity postoperatively, with a lower proportion of 83.9% with glaucoma than 96.9% and 100% without glaucoma and glaucoma suspect, respectively (P = 0.002). The mean visual acuity did not change in the glaucoma group (from 6/29 to 6/23), but it improved from 6/25 to 6/12 (a gain of 16.7 approxETDRS letters) in nonglaucoma and 6/26 to 6/14 in glaucoma suspect (a gain of 14.0 approxETDRS letters) (both P , 0.001). The change of visual acuity was correlated with preoperative visual field defects (P , 0.001, r 2 = 0.554). Patients with glaucoma with more advanced, fixationthreatening defects or temporally located inner nuclear layer microcysts were more likely to have worsened visual acuity.Conclusion: Visual field testing is imperative for patients with glaucoma before idiopathic epiretinal membrane surgery for outcome assessment.

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Section: Discussionsupporting

confidence: 89%

Factors Related to Unfavorable Visual Outcome After Idiopathic Epiretinal Membrane Surgery in Patients With Glaucoma

Chen

Huang

et al. 2022

Retina

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“…The epiretinal membrane (ERM) is a thin layer of fibrous tissue forming on the inner surface of the central retina. It causes metamorphopsia, monocular diplopia, and vision loss [1]. The exact etiology of this condition remains unknown, but it can be idiopathic or secondary to other ocular diseases, trauma, or previous intraocular operation.…”

Section: Introductionmentioning

confidence: 99%

Peripheral Retinal Degenerations and Idiopathic Epiretinal Membrane: Analysis with Ultra-Wide-Field Scanning Laser Ophthalmoscopy

Ulfik-Dembska

Teper

Dembski

et al. 2021

JCM

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Background: The present study examined the relationships among retinal structure, peripheral retinal abnormalities, and epiretinal membrane (ERM) and explored the utility of ultra-wide-field laser scanning ophthalmoscopy in idiopathic ERM assessment. Methods: The study sample comprised 276 eyes of 276 patients. Ultra-wide field fundus imaging was performed without mydriasis using Optos California. Each patient underwent a Goldmann three-mirror contact lens fundus examination. Results: Ultra-wide field laser scanning ophthalmoscopy revealed peripheral retinal degeneration in 84 (54.54%) eyes in the ERM and in 28 (22.95%) eyes in the control group. Goldmann three-mirror contact lens examination revealed peripheral retinal degeneration in 96 (62.33%) eyes in the ERM group and 42 (34.42%) eyes in the control group. Ultra-wide field ophthalmoscopy enabled the detection of nearly 87% of all peripheral retinal lesions in patients with ERM, but it cannot replace fundus examination with a Goldmann triple mirror or ophthalmoscopy with scleral indentation. Conclusions: In most patients, idiopathic ERM coexisted with changes in the peripheral retina. Some of these changes promote retinal detachment. Thus, surgeons should consider the risk of retinal tear during vitrectomy, which increases the scope of surgery and may adversely affect prognosis. Although ultra-wide field imaging is a valuable diagnostic method, it is not a substitute for Goldmann three-mirror contact lens fundus examination or ophthalmoscopy with scleral indentation.

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“…Transient changes in temporal nerve fiber layer thickness do not affect VA, 59 and visual fields do not deteriorate after vitrectomy for ERM with ILM peeling. 60 …”

Section: Discussionmentioning

confidence: 99%

“…Transient changes in temporal nerve fiber layer thickness do not affect VA, 59 and visual fields do not deteriorate after vitrectomy for ERM with ILM peeling. 60 An important limitation, concerns the fact that there are only few studies with histopathologic analysis for determining the extent of simultaneous ILM peel during ERM peeling. Also, it is unclear whether surgeons checked for positive ILM staining after the ERM removal.…”

Section: Discussionmentioning

confidence: 99%

Vitrectomy for the removal of idiopathic epiretinal membrane with or without internal limiting membrane peeling: a meta-analysis

et al. 2020

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Purpose: The aim of this study is to analyze the effect of internal limiting membrane peeling in removal of idiopathic epiretinal membranes through meta-analysis. Methods: We searched PubMed for studies published until 30 April 2018. Inclusion criteria included cases of idiopathic epiretinal membranes, treated with vitrectomy with or without internal limiting membrane peeling. Exclusion criteria consisted of coexisting retinal pathologies and use of indocyanine green to stain the internal limiting membrane. Sixteen studies were included in our meta-analysis. We compared the results of surgical removal of epiretinal membrane, with or without internal limiting membrane peeling, in terms of best-corrected visual acuity and anatomical restoration of the macula (central foveal thickness). Studies or subgroups of patients who had indocyanine green used as an internal limiting membrane stain were excluded from the study, due to evidence of its toxicity to the retina. Results: Regarding best-corrected visual acuity levels, the overall mean difference was –0.29 (95% confidence interval: –0.319 to –0.261), while for patients with internal limiting membrane peeling was –0.289 (95% confidence interval: –0.334 to –0.244) and for patients without internal limiting membrane peeling was –0.282 (95% confidence interval: –0.34 to –0.225). Regarding central foveal thickness levels, the overall mean difference was –117.22 (95% confidence interval: –136.70 to –97.74), while for patients with internal limiting membrane peeling was –121.08 (95% confidence interval: –151.12 to –91.03) and for patients without internal limiting membrane peeling was –105.34 (95% confidence interval: –119.47 to –96.21). Conclusion: Vitrectomy for the removal of epiretinal membrane combined with internal limiting membrane peeling is an effective method for the treatment of patients with idiopathic epiretinal membrane.

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Efficacy of 27-Gauge Vitrectomy with Internal Limiting Membrane Peeling for Epiretinal Membrane in Glaucoma Patients

Cited by 10 publications

References 32 publications

Factors Related to Unfavorable Visual Outcome After Idiopathic Epiretinal Membrane Surgery in Patients With Glaucoma

Factors Related to Unfavorable Visual Outcome After Idiopathic Epiretinal Membrane Surgery in Patients With Glaucoma

Peripheral Retinal Degenerations and Idiopathic Epiretinal Membrane: Analysis with Ultra-Wide-Field Scanning Laser Ophthalmoscopy

Vitrectomy for the removal of idiopathic epiretinal membrane with or without internal limiting membrane peeling: a meta-analysis

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