scholarly journals Risk of newly developing visual field defect and neurodegeneration after pars plana vitrectomy for idiopathic epiretinal membrane

2020 ◽  
pp. bjophthalmol-2020-317478
Author(s):  
Kunihiko Akino ◽  
Norihiro Nagai ◽  
Kazuhiro Watanabe ◽  
Norimitsu Ban ◽  
Toshihide Kurihara ◽  
...  

Background/AimsPars plana vitrectomy (PPV) is widely performed in patients with idiopathic epiretinal membrane (iERM) to improve vision. Postoperative visual field defects (VFDs) have been previously reported. However, whether they occur when using the most recent PPV system, and the frequency of VFDs as measured by standard automated perimetry, remain poorly documented and were examined in this study.MethodsData of 30 eyes (30 patients; mean age, 66.1 years; 15 men) who underwent PPV for iERM during February 2016–June 2019 and had preoperative and postoperative visual field measurements using standard automated perimetry (Humphrey visual field analyser 30-2 program) were retrospectively analysed. Eyes with diseases other than iERM, including moderate-to-severe cataract or preoperative VFDs were excluded.ResultsVFD, defined by the Anderson and Patella’s criteria, was found in 73.3% of the eyes 1 month after PPV. After age adjustment, internal limiting membrane (ILM) peeling was identified as a risk factor for postoperative VFD (p=0.035; 95% CI 1.173 to 92.8). Postoperative VFD was frequently observed nasally (86.4%, p=0.002), and on optical coherence tomography measurements, ganglion cell layer (GCL) thinning was found temporal to the fovea (p=0.008). Thinning of the superior and inferior retinal nerve fibre layers and of the GCL temporal to the fovea were significant in eyes after ILM peeling (all p<0.05).ConclusionILM peeling may cause inner retinal degeneration and lead to the development of VFDs after PPV, which should be further examined.

2015 ◽  
Vol 234 (3) ◽  
pp. 119-126 ◽  
Author(s):  
Kamil G. Laban ◽  
Laura M.E. Scheerlinck ◽  
Redmer van Leeuwen

Purpose: Pars plana vitrectomy with internal limiting membrane peeling for idiopathic epiretinal membrane has shown varying results. More data are needed on the factors associated with visual outcome. Methods: We extracted baseline clinical characteristics, optical coherence tomography (OCT) characteristics and 3-month postoperative best-corrected visual acuity (BCVA). Linear regression analysis was used to evaluate whether baseline and OCT characteristics are associated with BCVA at 3 months as well as BCVA difference. Results: Out of 82 operated eyes, 66 (80%) had a 3-month follow-up, and 47 (71%) showed a 3-month postoperative improvement. Preoperative BCVA was an independent determinant of postoperative BCVA (r = 0.31; p < 0.01) and BCVA difference (r = 0.68; p < 0.01). Other baseline and OCT characteristics showed no independent associations with postoperative outcome. Conclusion: Better preoperative BCVA predicts better postoperative BCVA. Other baseline and OCT characteristics are not associated with visual outcome 3 months after surgery.


2020 ◽  
Vol 14 (1) ◽  
pp. 1-8
Author(s):  
Tekin Aydin ◽  
Suleyman Gokhan Kerci ◽  
Omer Karti ◽  
Mehmet Ozgur Zengin ◽  
Tuncay Kusbeci

Backgrounds and Objective: Pars Plana Vitrectomy (PPV) and epiretinal membrane (ERM) peeling is the standard surgical procedure of ERM surgery. However, the effect of adding Internal Limiting Membrane (ILM) peeling to the standard surgery on macular function and structure remains still controversial. This study was aimed at investigating the effect of ILM peeling on the macular function and structure in idiopathic ERM surgery. Method: Thirty-six eyes of 34 patients were evaluated in this prospective study. The patients were divided into two groups (ILM peeling and non-ILM peeling group). While the removal of ERM was undergone alone in 19 eyes, it was combined with ILM peeling in 17 eyes. Metamorphopsia scores Vertical Metamorphopsia (VM) and Horizontal Metamorphopsia (HM), were measured at preoperative and 4 months postoperatively. Results: There was a statistically significant decrease in metamorphopsia (VM and HM) scores in both groups after the surgery. However, no statistically significant difference was found between the two groups in terms of reduction in VM scores and HM scores after surgery. Conclusion: Our study indicated that ILM peeling combined with ERM did not affect metamorphopsia scores.


2021 ◽  
Vol 4 (2) ◽  
pp. 178
Author(s):  
Madhurima Roy ◽  
Sangeeta Roy ◽  
Aniruddha Maiti ◽  
Nishita Yadav

A 59 years male presented with painless diminution of vision in right eye for 4 months. His vision was 20/100 in right eye and 20/30 in left eye. Fundus examination revealed epiretinal membrane  in right eye with central macular thickness of 747 μm for which he underwent 25 guage pars plana vitrectomy. Intraoperatively after internal limiting membrane peeling, during removal of the pieces of the membrane from the forceps with the endoilluminator pipe, accidentally one blade from the tip of ILM peeling forceps broke. In this report, we describe first case of inadvertent intraoperative fracture of 25- gauge Grieshaber DSP End-Grasping ILM forceps in a case of ERM who underwent vitrectomy and removal of ERM with successful removal of fractured tip of ILM forceps.


Retina ◽  
2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Michał Post ◽  
Maria Vittoria Cicinelli ◽  
Emma Clara Zanzottera ◽  
Alessandro Marchese ◽  
Francesco Bandello ◽  
...  

2015 ◽  
Vol 2015 ◽  
pp. 1-10 ◽  
Author(s):  
Hanhan Liu ◽  
Shanru Zuo ◽  
Chun Ding ◽  
Xunzhang Dai ◽  
Xiaohua Zhu

We conducted a meta-analysis of published retrospective studies and compared the effectiveness of pars plana vitrectomy with and without internal limiting membrane (ILM) peeling for idiopathic epiretinal membrane (IERM). The results revealed that patients in the IERM+ILM peeling group had better BCVA after surgery within 12 months than those in IERM peeling group. But patients in the IERM peeling group showed better BCVA in the 18th month. More retrospective studies or randomized controlled trials are required to investigate and compare the long-term effect of IERM removal with and without ILM peeling.


Author(s):  
Rani Pitta Omas

Introduction : Macular hole (MH) can cause severe visual disturbance, but remarkable progress has been achieved in surgical treatment for eyes with this condition. Vitrectomy with internal limiting membrane (ILM) peeling allows a very high success rate for MH closure (approaching 90%). To compare characteristics patients with closed and unclosed macular hole after pars plana vitrectomy (PPV) surgery and internal limiting membran (ILM) peeling. Method : This was retrospective study which data was obtain from patient’s medical records who underwent PPV and ILM peeling since July 1st to December 31th 2018. Results :  27 eyes from 25 patients had MH surgery. 20 eyes (74%)  had closed MH and 7 (26%) eyes unclosed MH after surgery. HFF value before surgery was 1,34 ± 0,90 and MHI was 1,09 ± 0,81 in closed MH. Meanwhile in unclosed MH, HFF value before surgery 0,53 ± 0,12 and MHI was 0,75 ±0,10. MHI ≥0,5 and HFF value ≥ 0,9 had a good prognostic factor. Conclusion : Despite of good prognostic factor from OCT measurement and achieve anatomical success,  foveal microstructure also important in  visual recovery after MH surgery.


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