OCT changes of idiopathic epiretinal membrane after cataract surgery

Vallejo-Garcia, Jose Luis; Romano, Mercedes; Pagano, Luca; Montericcio, Alessio; Borgia, Alfredo; Morenghi, Emanuela; Vinciguerra, Paolo

doi:10.1186/s40942-020-00239-8

Cited by 7 publications

(5 citation statements)

References 13 publications

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“…6,8,18,19 A previous report identified phacoemulsification as a significant risk factor. 21 Conversely, the comparison of the functional and anatomical outcomes of combined phacoemulsification/vitrectomy and vitrectomy only yielded similar results. 22 The association between phacoemulsification and ELM/EZ alteration cannot be explained solely by the longer time of the surgerybecause the procedure length was considered in the multivariable analysis.…”

Section: Discussionmentioning

confidence: 92%

Prevalence and Risk Factors of Ellipsoid Zone Damage After Pars Plana Vitrectomy for Idiopathic Epiretinal Membrane

Post

Cicinelli

Zanzottera

et al. 2022

Retina

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Purpose: To assess factors associated with external limiting membrane (ELM)/ellipsoid zone (EZ) damage after pars plana vitrectomy (PPV) for epiretinal membrane and evaluate ELM/EZ damage impact on functional and anatomical outcomes.Methods: Patients who underwent PPV with epiretinal membrane ± inner limiting membrane peeling were retrospectively analyzed. Best-corrected visual acuity and central macular thickness were longitudinally collected based on the available follow-up. Demographic data, clinical data, and surgical details were included in logistic regression models having ELM/EZ damage as a binary outcome.Results: Overall, 179 eyes (171 patients) were included; 93 had a 12-month follow-up. Thirty-four eyes (19%) had ELM/EZ damage after surgery; in nine eyes (5%), ELM/EZ damage persisted at 12 months. Phacoemulsification during PPV (odds ratio = 6.97; P = 0.007) and ELM/EZ damage before PPV (odds ratio = 6.91; P = 0.007) were risk factors for postoperative ELM/EZ disruption. Thicker outer nuclear layer (P = 0.002), thicker ectopic inner foveal layer (P , 0.001), and higher endoillumination power (P = 0.03) were associated with slower visual recovery. Inner limiting membrane peeling (P = 0.04) was associated with slower anatomical recovery.Conclusion: Cataract extraction and outer retinal damage before PPV are associated with higher risk of photoreceptor damage postoperatively. The rate of visual improvement varies as a function of retinal layers' distortion before surgery; additional retinal manipulation slows restoration of the macular anatomy.

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Section: Discussionmentioning

confidence: 92%

Prevalence and Risk Factors of Ellipsoid Zone Damage After Pars Plana Vitrectomy for Idiopathic Epiretinal Membrane

Post

Cicinelli

Zanzottera

et al. 2022

Retina

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“…A study conducted by Vallejo-Garcia et al [ 22 ] reported no statistically significant correlation between the stage of ERM and the development of CME. Their investigation utilized the Govetto classification and analyzed postoperative variables 1 month after cataract surgery.…”

Section: Discussionmentioning

confidence: 99%

Correlation between Severity of Idiopathic Epiretinal Membrane and Irvine–Gass Syndrome

Jeong,

Kang,

Lee

et al. 2023

JPM

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A higher risk of pseudophakic cystoid macular edema (PCME) has been reported in patients with preoperative idiopathic epiretinal membrane (ERM); however, whether the formation of PCME depends on the grade of ERM has not been well established. We conducted a retrospective case–control study of 87 eyes of 78 patients who were preoperatively diagnosed with idiopathic ERM and had undergone cataract surgery. Patients were divided into two groups: PCME and non-PCME groups. After cataract surgery, the ERM status was graded using the Gass and Govetto classifications. Both the central macular thickness (CMT) and ERM grade increased after surgery, and higher preoperative CMT and ERM grades were found in the PCME group. The association between higher-grade ERM and the development of PCME was significant in the Govetto classification (grade 2, odds ratio (OR): 3.13; grade 3, OR: 3.93; and grade 4, OR: 16.07). The study results indicate that close attention should be given to patients with ERM with the presence of an ectopic inner foveal layer before cataract surgery.

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“…Multiple studies have demonstrated increased rates of cystoid macular oedema (CMO) following cataract surgery in eyes with preexisting ERM compared with those without ERM. 11,[19][20][21] In the study by Schaub et al,15.7% of eyes with preexisting ERM developed postoperative CMO compared with only 5.9% of eyes without ERM. 11 Similarly, the retrospective study by Hardin et al, involving 812 eyes with ERM and 159,184 reference eyes, found that eyes with ERM were at significantly higher risk of postoperative CMO compared with eyes without ERM (8.6% versus 1.38%, respectively).…”

Section: Specific Pathologies To Consider Epiretinal Membranementioning

confidence: 99%

Combined Pars Plana Vitrectomy, Phacoemulsification and Intraocular Lens Implantation: A review on the Advantages and Limitations of Phacovitrectomy

Le¹,

Marshall²,

Houser³

et al. 2022

US Ophthalmic Review

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When vitreoretinal and anterior segment surgeons collaborate to perform concomitant cataract-vitreoretinal surgery (also known as phacovitrectomy) in the appropriate clinical setting, combined surgery can expedite visual recovery, improve the view and surgical access to the retina in cases with significant cataract, avoid multiple rounds of anaesthesia and reduce the financial burden on the patient. While combined surgery overcomes several limitations of sequential surgery, it is important to understand that phacovitrectomy may be associated with increased postoperative inflammation and less predictable refractive outcomes. We typically recommend combined phacovitrectomy in patients with significant cataract and vitreoretinal pathology, especially if the cataract impairs the view to the retina or if the patient is too ill to undergo several rounds of anaesthesia. In patients with high refractive expectations who have an early cataract or mild retinal pathology, combined surgery is not likely to be a viable or reasonable management option.

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OCT changes of idiopathic epiretinal membrane after cataract surgery

Cited by 7 publications

References 13 publications

Prevalence and Risk Factors of Ellipsoid Zone Damage After Pars Plana Vitrectomy for Idiopathic Epiretinal Membrane

Prevalence and Risk Factors of Ellipsoid Zone Damage After Pars Plana Vitrectomy for Idiopathic Epiretinal Membrane

Correlation between Severity of Idiopathic Epiretinal Membrane and Irvine–Gass Syndrome

Combined Pars Plana Vitrectomy, Phacoemulsification and Intraocular Lens Implantation: A review on the Advantages and Limitations of Phacovitrectomy

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