Occurrence rate of retinal detachment after small gauge vitrectomy for idiopathic epiretinal membrane

Marie-Louise, Jennifer; Philippakis, Elise; Darugar, Adil; Tadayoni, Ramin; Dupas, B.

doi:10.1038/eye.2017.79

Cited by 18 publications

(11 citation statements)

References 27 publications

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“…Detailed examination of the periphery with indentation before the finalization of the surgery may reveal retinal breaks during the surgery. One of the crucial complications of vitrectomy is the iatrogenic peripheral retinal tears which usually occur while inducing the posterior hyaloid detachment or performing peripheral vitreous shaving and should to be treated with laser photocoagulation promptly [14], [15], [16], [17]. In this study peripheral vitreous shaving with or without scleral indentation techniques were not performed in any cases, and no iatrogenic retinal tears were detected with this technique.…”

Section: Discussionmentioning

confidence: 79%

Subtotal vitrectomy in idiopathic macular hole surgery

Tarakçıoğlu

Tulu

Özkaya

2019

Saudi Journal of Ophthalmology

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PurposeTo assess the outcomes of subtotal vitrectomy in idiopathic macular hole (IMH).MethodsThe patients with idiopathic IMH who had undergone vitreoretinal surgery and followed up for at least 12 months post-operatively were included. First the posterior hyaloid was detached, then cortical vitreous was removed incompletely by leaving anterior vitreous intact. Internal limiting membrane was peeled with the aid of brilliant blue. A non-expanding volume of perfluoropropane was used as a tamponade and face-down positioning for 5 days was suggested to the patients. The main outcome measure was the closure rate of IMH.ResultsForty-three eyes were included. The mean follow-up time was 15.0 ± 3.8 months after surgery. Single surgery anatomical success was 86.0%. The mean BCVA at baseline, month 1, 3, 6, 12 and at the last follow-up was 0.99 ± 0.33 LogMAR (0,5–1.80), 1.04 ± 0.33 LogMAR (0.5–1.8), 0.94 ± 0.46 LogMAR (0.3–3.0), 0.84 ± 0.33 LogMAR (0.3–1.5), 0.82 ± 0.35 (0.2–1.5), and 0.70 ± 0.34 (0.1–1.5) (p > 0.05, for all). The mean visual acuity increased by 2.9 lines at the last follow-up visit and 51.2% of the patients gained ≥ 3 lines of vision.ConclusionThe results of this study indicated limited core vitrectomy as a safe and effective surgical technique in the treatment of IMH, resulting in acceptable functional and anatomical outcomes without significant intra- and post-operative complications.

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Section: Discussionmentioning

confidence: 79%

Subtotal vitrectomy in idiopathic macular hole surgery

Tarakçıoğlu

Tulu

Özkaya

2019

Saudi Journal of Ophthalmology

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“…Only 2 eyes of 212 eyes had postoperative retinal detachment. The authors concluded that small gauge sutureless vitrectomy improved the safety of ERM surgery (7).…”

Section: Discussionmentioning

confidence: 98%

İdyopatik Epiretinal Membranlı Hastalarda Sınırlı Vitrektomi

Özkan¹,

Karabaş²,

Tuğan³

et al. 2020

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Purpose: To evaluate the safety and effectivity of limited vitrectomy in patients with epiretinal membrane. Methods: We included 58 consecutive patients who underwent epiretinal membrane surgery without performing a complete peripheral vitreous removal. The improvement in visual acuity, the incidence of retinal breaks and detachment; anatomical results and intraoperative and postoperative complications of this technique were evaluated. Results: The median visual acuity was 0.4(0.3-0.5) before the surgery, and it was 0.6 (0.3-0.8) after the surgery (p=0.016). Prophylactic laser photocoagulation was performed in 14(24,13%) patients during surgery. Retinal breaks and detachments did not occur in any of our patients. We did not observe proliferative vitreoretinopathy or surgery-related major complications in any patient. Conclusion: Limited vitrectomy without removing peripheral vitreous is safe and effective in idiopathic epiretinal membrane surgery. It reduces the risk of peripheral retinal breaks and retinal detachment.

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“…Recent advances in vitreoretinal surgery have made ERM membrane surgery a very safe procedure [3, 10]. Together with the fact that in almost all reports, preoperative visual acuity is the main prognostic factor of postoperative visual acuity [2, 11, 12], this is leading to surgery being proposed to patients with very good visual acuities.…”

Section: Discussionmentioning

confidence: 99%

Epiretinal Membrane Surgery in Daily Clinical Practice: Results of a Proposed Management Scheme

Pareja

Coronado

Contreras

2019

Journal of Ophthalmology

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Purpose To report the results of the epiretinal membrane (ERM) management guidelines followed in our center. Methods Patients with ERM seen between 2014 and 2015, with ≥2 years follow-up or who had undergone ERM surgery, were included. Corrected visual acuity (VA), lens status, and ERM configuration were recorded at each visit. Our guidelines for ERM are if VA is ≥20/30, observation is recommended unless there is moderate/intense metamorphopsia. Vitrectomy is recommended during follow-up if there is a drop >one line in VA with changes in ERM configuration. If VA at diagnosis is <20/30, vitrectomy is recommended. If visual loss is thought to be due to cataract, phacoemulsification is performed first and visual status reevaluated. Results Ninety-nine eyes of 94 patients were included; 52 eyes underwent vitrectomy, and 47 eyes were monitored. From eyes with VA at diagnosis <20/30 (41 eyes), 8 eyes underwent isolated phacoemulsification: VA improved to ≥20/30. Vitrectomy was recommended but refused by 4 patients. The other 29 eyes underwent vitrectomy. Of the 58 eyes with VA at diagnosis ≥20/30, 5 underwent surgery due to metamorphopsia. Eighteen eyes underwent vitrectomy during follow-up. VA improved a mean of 0.13 logMAR (SD 0.30) after vitrectomy. There were no differences in mean VA improvement between eyes that underwent vitrectomy within six months of diagnosis (0.24, SD 0.32) and those that underwent surgery more than six months after diagnosis (mean 0.17, SD 0.17), p=0.106. Three eyes developed postsurgical complications with visual loss: persistent macular edema in one eye, two consecutive retinal detachments in one eye, and a central visual defect in another eye. At the end of follow-up, VA was similar in the observation group (0.14, SD 0.14) and in the vitrectomy group (0.16, SD 0.28), p=0.528. Conclusions Our proposed guidelines lead to visual preservation in most patients while limiting surgery and its possible complications.

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Occurrence rate of retinal detachment after small gauge vitrectomy for idiopathic epiretinal membrane

Cited by 18 publications

References 27 publications

Subtotal vitrectomy in idiopathic macular hole surgery

Subtotal vitrectomy in idiopathic macular hole surgery

İdyopatik Epiretinal Membranlı Hastalarda Sınırlı Vitrektomi

Epiretinal Membrane Surgery in Daily Clinical Practice: Results of a Proposed Management Scheme

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