Macular Pucker

Ripandelli, Guido; Scarinci, Fabio; Piaggi, Paolo; Guidi, G. M.; Pileri, Marco; Cupo, Gaetano; Sartini, Maria Sole; Parisi, Vincenzo; Baldanzellu, Sara; Giusti, C; Nardi, Marco; Stirpe, Mario; Lazzeri, Stefano

doi:10.1097/iae.0000000000000330

Cited by 118 publications

(62 citation statements)

References 43 publications

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“…4 Because of their central location on the macula, contraction of ERMs can be responsible for significant visual disability in the form of micropsia, macropsia, monocular diplopia, metamorphopsia and decline in visual acuity. 5 …”

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confidence: 99%

“…10 As an adjunct to reduce recurrence, most surgeons utilize a “double peeling” technique, which includes removal of the ILM. 5, 9, 11-13 Dyes utilized to stain the ILM include indocyanine green (ICG), trypan blue and brilliant blue G (BBG). 14 ILM peeling is believed to reduce the retinal striae seen postoperatively.…”

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confidence: 99%

“…20-22 Their functional significance remains controversial with previous studies showing no difference in visual acuity, sensitivity thresholds or microperimetry; 21, 23, 24 but more recent work by Ripandelli and associates, demonstrated that ILM peeling for ERM resulted in an overall decreased mean retinal sensitivity and increased number of microscotomas measured with microperimetry with 12 months of follow-up. 5 …”

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confidence: 99%

“…Most studies that follow the development of IRD have not extended past 12 months. 5, 9, 20-22, 25, 26 This current study investigated the long-term follow-up of patients who underwent macular pucker surgery by a single surgeon (SC) either with or without BBG dye-assisted second peel of the ILM and analyzed the visual and anatomic outcomes of these patients over 3 years.…”

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confidence: 99%

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Long-Term Retrospective Analysis of Visual Acuity and Optical Coherence Topographic Changes After Single Versus Double Peeling During Vitrectomy for Macular Epiretinal Membranes

Jung

Hoang

Ridley-Lane

et al. 2016

Retina

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Purpose To determine the long-term effect of internal limiting membrane (ILM) with associated epiretinal membrane (ERM) peeling versus single peeling alone in terms of best-correct visual acuity (BCVA) and anatomical outcomes on spectral-domain optical coherence tomography (SD-OCT). Methods This retrospective comparative cohort study of patients who had follow-up >1 year and underwent surgery for ERM by a single surgeon (SC) from January 1st, 2008-December 31st, 2012 compared cases in which the ILM was stained with brilliant blue G (BBG) to facilitate “double peeling” (n=42) to “single peeling” (n=43) of the ERM alone for up to 3 years of follow-up. For continuous variables, an independent 2-tailed t-test was performed. For binary variables, the Fisher exact test was performed. Statistical significance was defined as p<0.05. Results Eighty-five of 142 patients fit the inclusion criteria. At last follow-up, the single peeling group (SPG) were more likely to have ERM remaining in the central fovea postoperatively (p=0.0020, becoming significant by postoperative year 1, p=0.022) and less likely to develop inner retinal dimpling (IRD) (p=0.000, becoming significant by postoperative month 3, p=0.015). At 3 years, central foveal thickness had decreased in the SPG by −136.9-µm and by −84.1-µm in the double peeling group (DPG) respectively, which was not significantly different (p=0.08). Mean BCVA improved in both groups at all time points. There was no statistically significant difference between the two groups at 3 years (p=0.44, SPG=0.32±0.42, Snellen 20/42 (mean±standard deviation); DPG=0.23±0.27, Snellen 20/34). Conclusion BBG-assisted ILM peeling for ERM results in a more thorough removal of residual ERM around the paracentral fovea. However, there is no difference in long-term BCVA at 3 years and a greater likelihood of IRD.

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confidence: 99%

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confidence: 99%

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confidence: 99%

mentioning

confidence: 99%

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Long-Term Retrospective Analysis of Visual Acuity and Optical Coherence Topographic Changes After Single Versus Double Peeling During Vitrectomy for Macular Epiretinal Membranes

Jung

Hoang

Ridley-Lane

et al. 2016

Retina

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“…The ERM peeling group without ILM peeling showed higher reduction in central retinal thickness, but also higher ERM recurrence rates [35]. Furthermore, it was reported that in the ERM and ILM peeling group more absolute microscotomas in microperimetry occur compared to the ERM peeling group without ILM peeling [36]. As the results concerning visual acuity are controversial, the decision whether to peel the ILM or not is still not finally answered.…”

Section: Discussionmentioning

confidence: 99%

Intraoperative Optical Coherence Tomography-Guided Membrane Peeling for Surgery of Macular Pucker: Advantages and Limitations

et al. 2018

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Purpose: Epiretinal membranes (ERMs) are a disorder leading to progressive vision loss and metamorphopsia. The gold standard in therapy is vitrectomy with membrane peeling. The aim of this study was to assess whether the use of intraoperative optical coherence tomography (iOCT), which allows tomographic visualization of the membrane during peeling, enables peeling without staining. Methods: This prospective study included 30 eyes of 30 patients with idiopathic ERMs scheduled for surgery. Pars plana vitrectomy with iOCT was performed in all cases, whereas staining of ERMs was only performed if needed. Internal limiting membrane (ILM) peeling was performed in case of wrinkled retinal surface after peeling of ERMs. Results: In 63% (n = 19) eyes the ERM could be peeled successfully without use of staining. Nevertheless, in 89% (n = 17) of patients having had ERM peeling without dye, staining of the ILM was performed afterwards for peeling the ILM. Best corrected visual acuity improved in 80% (n = 24) and remained unchanged in 7% (n = 2) 3 months after surgery. There were no significant differences in postoperative results between patients with and without staining for ERM peeling. Conclusions: Use of iOCT helps to complete ERM peeling in a majority of cases without use of a chromovitrectomy dye, but as iOCT fails to visualize the ILM, chromovitrectomy still facilitates macular surgery in a majority of cases.

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Macular Epiretinal Membrane Surgery

Morizane

Kanzaki

2022

Albert and Jakobiec's Principles and Practice of Ophthalmology

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Macular Pucker

Abstract: The ILM not peeling group seems to show better outcomes than the ILM peeling group as measured by mean retinal sensitivity and number of microscotomas after a 12-month follow-up.

Cited by 118 publications

References 43 publications

Long-Term Retrospective Analysis of Visual Acuity and Optical Coherence Topographic Changes After Single Versus Double Peeling During Vitrectomy for Macular Epiretinal Membranes

Long-Term Retrospective Analysis of Visual Acuity and Optical Coherence Topographic Changes After Single Versus Double Peeling During Vitrectomy for Macular Epiretinal Membranes

Intraoperative Optical Coherence Tomography-Guided Membrane Peeling for Surgery of Macular Pucker: Advantages and Limitations

Macular Epiretinal Membrane Surgery

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