Long-Term Outcome of Epiretinal Membrane Surgery in Patients with Internal Limiting Membrane Dehiscence

Abstract

Purpose: To identify the effect of internal limiting membrane (ILM) dehiscence on surgical outcomes in eyes that have undergone epiretinal membrane (ERM) removal. Methods: Consecutive eyes with performed vitrectomy for ERM removal were included. Subjects were divided into two groups: patients with ILM dehiscence (group 1) and without ILM dehiscence (group 2). The best-corrected visual acuity (BCVA) and retinal layer thickness before and after surgery were compared between the two groups. Results: A total of 86 eyes were enrolled. Forty-six eyes (53.5%) showed ILM dehiscence before surgery. The baseline BCVAs were 0.46 ± 0.29 and 0.45 ± 0.25 in groups 1 and 2, respectively (p = 0.801). The BCVAs at 3, 6, and 12 months after surgery differed significantly between the two groups. The subfoveal thickness and inner retinal layer thickness (IRLT) of group 1 vs. 2 were 507.4 ± 80.0 vs. 417.6 ± 63.6 μm, and 270.2 ± 74.3 vs. 182.6 ± 60.4 μm, respectively (both p < 0.001). These differences between the groups remained significant until 12 months after surgery. In multivariate analyses, the location of ILM dehiscence (B = −0.105, p = 0.034) and final IRLT (B = 0.001, p = 0.046) were significant factors affecting the final BCVA. Conclusions: ILM dehiscence is a relatively common finding and associated with preoperative and postoperative increased IRLT, which results in worse surgical outcomes compared to the absence of ILM dehiscence in patients with ERM. Additionally, the final BCVA was significantly affected by its location and final IRLT in patients with ILM dehiscence.

Changes in each retinal layer and ellipsoid zone recovery after full-thickness macular hole surgery

“…Actually, the reduction in IRL was associated with BCVA improvement in our study. Such a reduction may be one of the healing processes after sealing of the FTMH, similar to the process after surgery for the epiretinal membrane, as opposed to contributing to microvasculature impairment 11 , 22 . Further longitudinal studies for changes in macular microvasculature using optical coherence tomography angiography are needed.…”

“…This prospective observational study adhered to the tenets of the Declaration of Helsinki and was approved by the Institutional Review Board of Konyang University Hospital, Daejeon, Korea, and informed consent was obtained from all of the patients. We obtained detailed histories and best-corrected visual acuity (BCVA), intraocular pressure, spherical equivalent, and axial length 11 . All patients underwent 25-gauge PPV with ILM peeling using indocyanine green, and fluid-gas exchange using C 3 F 8 or SF 6 with face down posturing.…”

Clinical Implication of Retinal Nerve Fiber Layer Schisis and Macular Fluorescein Leakage in Primary Idiopathic Epiretinal Membrane

“…12,13 Internal limiting membrane dehiscence is not associated with preoperative visual acuity, but with poor final postoperative visual acuity. 11,19 This study showed that preoperative BCVA was worse in cases with RNFL schisis and postoperative BCVA was worse, and the degree of improvement in BCVA was lower in cases with macular fluorescein leakage. Postoperative BCVA was worse in patients with both macular fluorescein leakage and RNFL schisis than in those without both factors (Figure 3).…”

“…12,13 Internal limiting membrane dehiscence is not associated with preoperative visual acuity, but with poor final postoperative visual acuity. 11,19…”

Correction: Lee et al. Long-Term Outcome of Epiretinal Membrane Surgery in Patients with Internal Limiting Membrane Dehiscence. J. Clin. Med. 2020, 9, 2470

“…The authors would like to correct the keyword ‘bare RNLF’ to ‘RNFL schisis’ in their prior publication [ 1 ]. The word ‘bare RNFL’ was first used in a previous study published 2 months before these authors’ paper [ 2 ].…”