Intraoperative Foveal Traction in Patients with Epiretinal Membrane

Abstract

Purpose: To determine influences of intraoperative foveal traction during membrane peeling in idiopathic epiretinal membrane (ERM) surgery. Methods: This retrospective observational study included 46 eyes of 46 patients with idiopathic ERM who underwent pars plana vitrectomy with ERM and internal limiting membrane peeling from February 2015 to September 2015. The presence of intraoperative foveal traction during membrane peeling was reviewed using video records. The main outcome measures were best-corrected visual acuity (BCVA), central foveal thickness (CFT), foveal contour, and photoreceptor inner segment/outer segment junction disruption using optical coherence tomography at baseline and at 1, 3, 6, and 12 months after surgery. Results: Group 1 (ERM with intraoperative foveal traction) included 22 eyes, and group 2 (ERM without intraoperative foveal traction) included 24 eyes. Preoperatively, convex pattern ERM was observed more often in group 1. Group 1 had a significantly thicker CFT and a lower BCVA compared to group 2 at baseline and during the first 6 months, but the final postoperative BCVA and CFT were not significantly different between the groups at 12 months. Among 22 eyes, 12 eyes (54.5%) were restored to flat or concave ERM patterns at an average of 5.4 months after surgery in group 1, and 18 out of 24 eyes (75%) recovered at 2.4 months (p < 0.01) in group 2. Conclusions: Preoperative thick CFT and convex pattern ERM indicated a high possibility of intraoperative foveal traction in idiopathic ERM surgery. There were no differences in long-term BCVA and restoration of foveal configuration according to foveal traction during membrane peeling. J Korean Ophthalmol Soc 2018;59(8): [738][739][740][741][742][743][744]

Surgical Outcomes in Idiopathic Epiretinal Membrane Surgery with or without Gas Tamponade

“…눈 속 가스 충전은 1911년 망막박리의 치료로 처음 눈 속 공 기를 주입하여 성공적인 망막유착을 이뤄낸 이후 망막박리, 황반원공, 근시중심와층간분리 등 다양한 망막 질환의 수술 에 이용되고 있다 [7,8]. 망막앞막에서도 유리체절제술과 망 막앞막 및 내경계막제거술을 시행한 뒤 망막의 상태에 따라 막 제거 중 중심와 견인이 있어 보이거나 혹은 망막의 주름 을 펴고 편평하게 하기 위해 가스 충전술을 시행할 수도 있 다 [9][10][11][12][13]. 이렇듯 다양한 용도로 사용되는 가스 충전술의 효 과에 대해 과거 연구들은 주로 황반원공이나 근시중심와층 간분리 등에 한정되어 있었다 [7,8,14,15].…”