&lt;p&gt;Outcomes of Epiretinal Membrane Removal Utilizing Triamcinolone Acetonide Visualization and Internal Limiting Membrane Forceps&lt;/p&gt;

Asahi, Masumi G; Wallsh, Josh; Gallemore, Ron P.

doi:10.2147/opth.s279611

Cited by 7 publications

(3 citation statements)

References 30 publications

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“…Since its first introduction, many advancements have been achieved in the field of ERM surgery, including the implementation of dyes for better visualization [ 14 , 15 ] and new surgical instruments for safer and more efficient removal. Additionally, further investigations are being undertaken to assess the importance of adjunctive ILM peeling [ 16 , 17 ]. The present study aimed to observe ERM surgery from a mechanical standpoint, evaluating the presence of significant differences in the peeling dynamics under different vitreal mediums and relating them to potential differences in structural and functional postoperative outcomes.…”

Section: Discussionmentioning

confidence: 99%

Dynamics of Epiretinal Membrane Peeling under Perfluorocarbon Liquid Evaluated by Intraoperative OCT

Caporossi

Picardi

Gambini

et al. 2023

Life

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Background: The aim of this study is to provide intraoperative data demonstrating a significant difference in the membrane peeling dynamics performed under a perfluorocarbon (PFCL) bubble, compared to normal balanced saline solution (BSS). Methods: This is a prospective, interventional, single-center study on a series of 36 consecutive eyes of 36 patients affected by primary epiretinal membrane (ERM). Eighteen eyes underwent standard ERM peeling, while 18 eyes received a PFCL-assisted procedure. Intraoperative optical coherence tomography (iOCT) B-Scans were collected to evaluate the displacement angle (DA) between the underlying retinal plane and the flap of epiretinal tissue, along with the number of times the surgeon had to grab the flap during the intervention. Follow-up visits were carried out at postoperative week 1 and months 1, 3 and 6. Results: The mean DA was 164.8° ± 4.0 in the PFCL-assisted group and 119.7° ± 8.7 in the standard group, with a statistically significant difference between groups (p < 0.001). Moreover, we found a significant difference in the amount of ERM grabs between the two groups (7.2 ± 2.5 in the PFCL-assisted group vs. 10.3 ± 3.1 in the standard group, p = 0.005). The mean BCVA and metamorphopsia significantly improved in both groups (p < 0.05), with no significant intergroup difference at all follow-up visits. Similarly, CST significantly decreased in both groups, and final CST was similar between the two groups (p = 0.719). Overall, three eyes in the standard group developed postoperative dissociated optic nerve fiber layer (DONFL, 16.6%), compared to none of the PFCL-assisted group. Conclusion: We reported a statistically significant difference in the intraoperative peeling dynamics of the PFCL-assisted group, accounting for a decreased tendency in the tearing of the ERM flap and possibly reduced damage to the fiber layer, with equal effectiveness in improving visual function and foveal thickness.

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Section: Discussionmentioning

confidence: 99%

Dynamics of Epiretinal Membrane Peeling under Perfluorocarbon Liquid Evaluated by Intraoperative OCT

Caporossi

Picardi

Gambini

et al. 2023

Life

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“…We previously reported a similar rate of glaucoma in eyes treated with TA-assisted ILM peel for epiretinal membranes. 57 In both cases, it is unclear whether this progression can be directly correlated with the brief intraoperative exposure to TA as there is an inherent risk of elevated IOP associated with vitrectomy alone. 58 , 59 This risk is further increased with the use of C3F8 gas tamponade.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Outcomes of Macular Hole Repair with Triamcinolone Acetonide Visualization

Wallsh¹,

Asahi²,

Gallemore³

2021

OPTH

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Purpose To evaluate the long-term anatomic and visual outcomes of macular hole (MH) repair utilizing triamcinolone acetonide (TA) visualization of the internal limiting membrane (ILM) treated at a tertiary care retina practice. Methods Retrospective chart review of eyes undergoing MH repair with ILM peel utilizing TA visualization followed by gas tamponade and facedown positioning between 2014 and 2020. Pre- and post-operative visual acuity (VA), IOP, and anatomic closure based on optical coherence tomography were documented. Results Seventy-eight eyes were followed for 2.3±0.2 years after primary repair with anatomic closure in 73 (94%) eyes at their final visit and excluding eyes with pathologic myopia, 97%, and for stage 2 and small MHs, 100%. In all eyes, VA significantly improved from 0.97±0.04 (Snellen: 20/187) to 0.66±0.06 (20/91) logMAR (p < 0.0001). There were 16 eyes with 4 years of follow-up, 10 (63%) eyes achieving a VA ≥20/30 at that follow-up visit. Stage 2 and 3 MHs had significantly greater improvements in VA than Stage 4 MHs, −0.46 ± 0.06 versus −0.11 ± 0.11 logMAR (p = 0.021). Of the 13 (17%) eyes with recurrent MHs, 6 (46%) had pathologic myopia and 8 (61.5%) had associated cystoid macular edema. Cataract progression was reported in 52 (96%) phakic eyes and 2 eyes required Ahmed valve placement for management of pre-existing glaucoma. Conclusion Long-term results of MH repair with TA for ILM visualization demonstrate that it is safe and effective. Visual acuity continued to improve throughout the follow-up. Pre-existing glaucoma may progress and recurrence is associated with pathologic myopia and macular edema.

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“…Postsurgical macular edema can present in nearly 25%–27% of ERM cases with or without combined cataract extraction, and this incidence can be even higher in the higher phase of ERMs ( Iuliano et al, 2021 ). Several recent publications have proposed that triamcinolone acetonide (TA), intravitreally injected when the surgery is nearly completed, was capable of accelerating intraretinal edema resorption and hastening visual acuity enhancement ( Asahi et al, 2020 ; Mandelcorn et al, 2022 ). Nevertheless, its application has been limited by the increase of intraocular pressure (IOP) and the risk of postoperative uveitis mimicking infectious endophthalmitis.…”

Section: Introductionmentioning

confidence: 99%

Intraoperative slow-release dexamethasone intravitreal implant (Ozurdex) in epiretinal membrane peeling surgery: a prospective randomized controlled trial

Li,

Zeng,

Zhu

et al. 2023

Front. Pharmacol.

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Purpose: This study aimed to determine the efficacy of the dexamethasone (DEX) intravitreal implant for the regression of macular edema and the improvement of best-corrected visual acuity (BCVA) after the removal of idiopathic epiretinal membrane (ERM).Methods: This prospective randomized controlled trial recruited 81 patients with idiopathic ERM. These patients all underwent 25-gauge pars plana vitrectomy combined with ERM and internal limiting membrane peeling surgery. Among them, 41 eyes in the DEX group received additional DEX implants and 40 in the non-DEX group did not. Outcomes including central retinal thickness (CRT), BCVA, and intraocular pressure were measured 1 and 3 months after surgery.Results: The DEX group had thinner CRTs compared to the non-DEX group at 1 month postoperatively (p <0.05), but did not differ significantly at the 1-week and 3-month follow-up visits (p = 0.109 and p = 0.417, respectively). There were no statistical differences with respect to BCVA (p = 0.499, 0.309, 0.246, and 0.517, respectively) and intraocular pressure (p = 0.556, 0.639, 0.741, and 0.517, respectively) between the two groups at each point of follow-up visits.Conclusion: DEX accelerated the reduction of CRT at 1 month after surgery. However, no evidence of further anatomical (CRT) or functional (BCVA) benefits using DEX was observed at 3 months.Clinical Trial Registration:https://clinicaltrials.gov/, identifier NCT05416827.

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<p>Outcomes of Epiretinal Membrane Removal Utilizing Triamcinolone Acetonide Visualization and Internal Limiting Membrane Forceps</p>

Cited by 7 publications

References 30 publications

Dynamics of Epiretinal Membrane Peeling under Perfluorocarbon Liquid Evaluated by Intraoperative OCT

Dynamics of Epiretinal Membrane Peeling under Perfluorocarbon Liquid Evaluated by Intraoperative OCT

Long-Term Outcomes of Macular Hole Repair with Triamcinolone Acetonide Visualization

Intraoperative slow-release dexamethasone intravitreal implant (Ozurdex) in epiretinal membrane peeling surgery: a prospective randomized controlled trial

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