Role of internal limiting membrane peeling in the prevention of epiretinal membrane formation following vitrectomy for retinal detachment: a randomised trial

Kumar, Vinod; Dubey, Devashish; Kumawat, Devesh; Markan, Ashish; Chandra, Parijat; Chandra, Mahesh; Kumar, Atul

doi:10.1136/bjophthalmol-2019-315095

Cited by 13 publications

(26 citation statements)

References 23 publications

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“…26 It also reduces the chances of post-operative epiretinal membrane (ERM) formation and retinal re-detachment. [27][28][29][30][31] More than 50% of eyes in our series achieved final BCVA≥20/80 while 25% of eyes achieved BCVA between 20/120-20/200. The causes for suboptimal visual gain were the development of RRD, vascular occlusion, and macular pathologies like FTMH, SRH, and macular pucker.…”

Section: Discussionmentioning

confidence: 99%

Clinical Presentation and Management of Eyes with Globe Perforation during Peribulbar and Retrobulbar Anesthesia: A Retrospective Case Series

Babu

Kumar

Kohli

et al. 2022

Korean J Ophthalmol

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Purpose: To evaluate the clinical presentation, management, and outcome of eyes with an inadvertent globe perforation during peribulbar or retrobulbar block.Methods: This retrospective study evaluated the eyes which had an accidental globe perforation during local ocular anesthesia from 2012 to 2020. The patients were divided into three groups: group 1, Clear media with no rhegmatogenous retinal detachment (RRD); group 2, significant vitreous hemorrhage (VH) precluding the retinal view without RRD; and group 3, RRD with/without VH.Results: Twenty-five patients were included in the study. The mean axial length (AL) was 24.7 ± 2.7 mm (range, 20.9–31.2 mm). The most common presenting feature was VH (n = 14). The treatment included retinal laser barrage (n = 7) and vitrectomy (n = 17). Retinal breaks were identified in all the eyes (total breaks = 37). The mean presenting best-corrected visual acuity in groups 1, 2, and 3 were logarithm of the minimum angle of resolution 0.79 ± 0.73, 1.82 ± 0.78, and 2.13 ± 0.59 respectively. All the treated patients had an attached retina at the last follow-up. The mean final best-corrected visual acuity for each group was logarithm of the minimum angle of resolution 0.59 ± 0.79, 0.48 ± 0.26, and 1.25 ± 0.64, respectively (p = 0.006). The development of RRD was associated with a larger AL (p = 0.015); while the development of significant VH associated with the superior location of the perforation (p = 0.015), late recognition of the perforation (p = 0.004), and multiple perforations (p = 0.015).Conclusions: Early recognition and intervention in eyes with an inadvertent perforation can lead to a good outcome. Eyes with a longer AL, superior, and multiple perforations are at higher risk of developing complications like RRD and VH. Complications like RRD, macular injury, and vascular occlusion are risk factors for poor prognosis.

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Section: Discussionmentioning

confidence: 99%

Clinical Presentation and Management of Eyes with Globe Perforation during Peribulbar and Retrobulbar Anesthesia: A Retrospective Case Series

Babu

Kumar

Kohli

et al. 2022

Korean J Ophthalmol

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“…La incidencia de membrana epirretiniana después de una vitrectomía superó las encontradas por Takamidou et al 12 (2.4%, n = 1736) e Ishikawa et al 13 15 (74.9%, n = 64), quienes solo evaluaron con TCO y no encontraron afección visual en los pacientes. En estudios comparativos para evaluar la incidencia de membranas epirretinianas después de vitrectomía con y sin retiro de la membrana limitante interna se reportan incidencias del 20% (Kumar et al 16 , n = 30), el 31% (Forlini et al 17 , n = 81) y el 46.4% (Arias et al 18 , n = 140) en los ojos que se intervinieron sin remoción quirúrgica de la membrana limitante, lo cual es consistente con los IC95% de nuestro estudio. La remoción quirúrgica de la membrana limitante interna durante la vitrectomía casi elimina la incidencia posoperatoria de membrana epirretiniana, pero puede llevar a una menor recuperación visual y a otras alteraciones funcionales clínicas o subclínicas 11,19 .…”

Section: Discussionunclassified

Incidencia y tiempo de aparición de membranas epirretinianas después de dos técnicas de retinopexia

Quiroz-González¹,

Montaño²,

Lima-Gómez³

2022

CIRU

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Objetivo: Comparar la incidencia y el tiempo en que aparecen las membranas epirretinianas después de dos técnicas quirúrgicas para tratar el desprendimiento de retina (retinopexia). Método: Estudio observacional, retrospectivo, longitudinal y comparativo en pacientes operados por desprendimiento regmatógeno primario de retina sin una membrana epirretiniana al momento de la cirugía, divididos en grupos: operados mediante criorretinopexia/cerclaje escleral (grupo 1) o vitrectomía (grupo 2). Se compararon entre grupos la incidencia de membrana epirretiniana, la mediana del tiempo de aparición (U de Mann-Whitney) y las proporciones de ojos sin membrana epirretiniana temporalmente mediante un análisis de sobrevida (logrank). Resultados: En 112 ojos en el grupo 1 y 48 ojos en el grupo 2, la incidencia de membrana epirretiniana fue del 23.2% en el grupo 1 y del 20.8% en el grupo 2 (p = 0.8). La mediana del tiempo de aparición fue de 12 semanas en el grupo 1 (rango intercuartílico [RIC]: 8.75-16) y de 18 semanas en el grupo 2 (RIC: 12.5-22; p = 0.02). La prueba de log-rank no mostró diferencias en la incidencia durante el seguimiento (p = 0.6). Conclusiones: Las membranas epirretinianas se presentan tempranamente después de una retinopexia, antes en ojos operados mediante criorretinopexia. De acuerdo con la incidencia observada, su búsqueda podría empezar 2 meses después de un cerclaje y 3 meses después de una vitrectomía.

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“…In addition to the demonstrated advantage of macular ILM peeling on rates of surgical success, we found that postoperative ERM formation was significantly reduced when macular ILM peeling was performed compared with not (7.4% vs. 18.8%; P = 0.01) (Table 4), in keeping with a recent study. 19 Furthermore, macular ILM peeling may be of particular benefit in phacovitrectomy where combined surgery has been shown to lead to more intense postoperative inflammation 7 with a presumably higher risk of postoperative ERM development.…”

Section: Discussionmentioning

confidence: 99%

Phacovitrectomy for Primary Rhegmatogenous Retinal Detachment Repair

Benson

Sia²,

Seamone³

et al. 2021

Retina

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To analyze the single surgery success rate and anterior segment complications related to phacoemulsification and intraocular lens implantation in a series of patients undergoing phacovitrectomy for all types of primary rhegmatogenous retinal detachment.Methods: We performed a retrospective interventional case series on 302 eyes undergoing phacovitrectomy for primary rhegmatogenous retinal detachment repair between November 1, 2016, and February 2, 2019, in Edmonton, Canada. Primary outcomes included single surgery retinal reattachment rate and anterior segment complications. Secondary outcomes included the effects of proliferative vitreoretinopathy and macula and/or peripheral internal limiting membrane peeling on the rate of surgical success.Results: The single surgery success rate of phacovitrectomy for all types of primary rhegmatogenous retinal detachment was 85.1%. The presence of proliferative vitreoretinopathy was associated with lower surgical success (odds ratio, 0.33; P = 0.01). Macular internal limiting membrane peeling was associated with higher surgical success (odds ratio, 2.4; P = 0.05). Anterior segment complications included posterior capsular opacification (28.8%), posterior synechiae (10.9%), and posterior capsular rupture (2.3%).Conclusion: Phacovitrectomy is a safe and effective treatment option for the primary repair of rhegmatogenous retinal detachments. This study provides evidence to support the safe incorporation of phacoemulsification and intraocular lens implantation with retinal surgery.

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Role of internal limiting membrane peeling in the prevention of epiretinal membrane formation following vitrectomy for retinal detachment: a randomised trial

Cited by 13 publications

References 23 publications

Clinical Presentation and Management of Eyes with Globe Perforation during Peribulbar and Retrobulbar Anesthesia: A Retrospective Case Series

Clinical Presentation and Management of Eyes with Globe Perforation during Peribulbar and Retrobulbar Anesthesia: A Retrospective Case Series

Incidencia y tiempo de aparición de membranas epirretinianas después de dos técnicas de retinopexia

Phacovitrectomy for Primary Rhegmatogenous Retinal Detachment Repair

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