scholarly journals Internal Limiting Membrane Peeling versus Nonpeeling to Prevent Epiretinal Membrane Formation following Vitrectomy for Posterior Segment Open-Globe Injury

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Wen-Long Wei ◽  
Zhong Lin ◽  
Ming-Na Xu ◽  
Ke-Mi Feng ◽  
Zhen-Quan Zhao
Keyword(s):  
Visual Acuity ◽  
Confidence Interval ◽  
Epiretinal Membrane ◽  
Odds Ratio ◽  
Internal Limiting Membrane ◽  
Posterior Segment ◽  
Open Globe Injury ◽  
Ilm Peeling ◽  
Open Globe ◽  
Surgical Data

Purpose. Approximately 30% of patients with an open-globe injury (OGI) develop a secondary epiretinal membrane (ERM). This study was performed to assess whether internal limiting membrane (ILM) peeling in the treatment of posterior segment OGI prevents ERM formation. Methods. The medical records of 33 patients who underwent vitrectomy for posterior segment OGI from 2016 to 2019 were retrospectively analyzed. Of these patients, 17 underwent ILM peeling during the vitrectomy and 16 did not. The patients’ demographic and surgical data were collected. The associations of ILM peeling with the preoperative findings of posterior segment OGI and development of a postoperative ERM were analyzed. Student’s t-test was used to evaluate differences in continuous variables, and the chi-squared test or Fisher’s exact test was used for categorical variables. Time-to-event curves were calculated from postestimation Cox proportional hazards models. Results. An ERM developed in three eyes (17.6%) in the ILM peeling group and in eight eyes (50.0%) in the nonpeeling group ( p < 0.05 ). There was no statistically significant difference between the groups in visual acuity at baseline (1.68 vs. 1.58 logMAR, p = 0.68 ) or at final follow-up (0.72 vs. 0.78 logMAR, p = 0.66 ). Median visual acuity significantly improved in both groups ( p < 0.001 ). In the multivariable models, ILM peeling (odds ratio, 0.19; 95% confidence interval, 0.04–0.91; p = 0.04 ) and worse preoperative vision (odds ratio, 0.29; 95% confidence interval, 0.10–0.80; p = 0.02 ) were associated with lower likelihood of ERM formation. Conclusion. Preventative treatment with ILM peeling contributed to decreased development of an ERM in patients with OGI involving areas near the fovea.

scholarly journals Effect of internal limiting membrane peeling on postoperative visual acuity in macula-off rhegmatogenous retinal detachment

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0255827
Author(s):  
Shumpei Obata ◽  
Masashi Kakinoki ◽  
Osamu Sawada ◽  
Yoshitsugu Saishin ◽  
Yusuke Ichiyama ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Cataract Surgery ◽  
Epiretinal Membrane ◽  
Rhegmatogenous Retinal Detachment ◽  
Internal Limiting Membrane ◽  
Ilm Peeling ◽  
Membrane Formation ◽  
Explanatory Variables ◽  
Long Duration

Purpose To investigate the effects of internal limiting membrane (ILM) peeling on visual acuity (VA) after rhegmatogenous retinal detachment (RRD) surgery. Methods This retrospective analysis examined the medical records of patients with RRD who underwent vitrectomy at 26 institutions. To detect prognostic factors of VA at 6 months postoperatively (post-VA), multivariate linear regression was performed with post-VA as the objective variable; ILM peeling, sex, age, preoperative VA (pre-VA), intraocular pressure, axial length, duration of RRD, and cataract surgery served as explanatory variables. Recurrence of RRD and epiretinal membrane formation within 6 months postoperatively were compared between groups of patients with and without ILM peeling, among patients with macula-on and macula-off RRD. Results The inclusion criteria were met by 523 eyes with a macula-on RRD and 364 eyes with a macula-off RRD. ILM peeling was performed in 85 eyes with a macula-on RRD and 57 eyes with a macula-off RRD. In eyes with a macula-on RRD, ILM peeling did not affect post-VA (p = 0.72). Vitrectomy without cataract surgery and poor pre-VA were significantly associated with poor post-VA (p = 0.01 and p < 0.001, respectively). In eyes with a macula-off RRD, ILM peeling, long duration of RRD, and poor pre-VA were significantly associated with poor post-VA (p = 0.037, p = 0.007, and p < 0.001, respectively). Recurrence of RRD and epiretinal membrane formation were similar between groups of patients with and without ILM peeling, among patients with macula-on and macula-off RRD. Retina sensitivity was not evaluated by microperimetry. Conclusion ILM peeling did not affect post-VA in eyes with a macula-on RRD, whereas post-VA was worse in eyes with ILM peeling than in eyes without peeling, among eyes with a macula-off RRD.

scholarly journals Role of Concomitant Internal Limiting Membrane (ILM) Peeling during Rhegmatogenous Retinal Detachment (RRD) Surgery in Preventing Postoperative Epiretinal Membrane (ERM) Formation

2021 ◽  
Vol 37 (3) ◽  
Author(s):  
Asaad Mahmood Syed ◽  
Fawad Rizvi Syed ◽  
Burhan Abdul Majid Khan ◽  
Tanweer Hasan Khan
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Epiretinal Membrane ◽  
Rhegmatogenous Retinal Detachment ◽  
Internal Limiting Membrane ◽  
Ilm Peeling ◽  
Group A ◽  
Group B ◽  
Sd Oct

Objective: To investigate the role of concomitant Internal Limiting Membrane (ILM) peeling during surgery for macula off Rhegmatogenous Retinal Detachment (RRD) in preventing postoperative Epiretinal Membrane (ERM) formation; and its effect on the visual acuity. Methods: This was a prospective, quasi-experimental study conducted from August 2018 to July 2019 at LRBT Tertiary Eye Care hospital, Karachi. Fifty-six patients with macula off RRD were divided into groups A (with ILM peeling) and B (without ILM peeling) via non-probability convenience sampling. All patients underwent standard 3 ports pars plana vitrectomy with silicon oil tamponade. In Group-A, ILM was stained using 0.5% ICG. Patients were evaluated clinically and by spectral domain optical coherence tomography (SD-OCT), pre- and post-operatively. Main outcomes recorded were best corrected visual acuity (BCVA) and occurrence of ERM on SD-OCT. Results: There were 26 patients in Group-A and 30 patients in Group-B. At six months’ follow-up, ERM had not developed in any case in Group-A compared to five patients (16.7%) in Group-B. There was no statistical difference in mean BCVA change from baseline. Conclusion: ILM peeling during vitrectomy for RRD prevents the formation of macular ERM post-operatively. This may reduce the need of a second vitrectomy. However, visual outcomes were comparable to the non-ILM peeling vitrectomy. doi: https://doi.org/10.12669/pjms.37.3.3576 How to cite this:Mahmood SA, Rizvi SF, Khan BAM, Khan TH. Role of Concomitant Internal Limiting Membrane (ILM) Peeling During Rhegmatogenous Retinal Detachment (RRD) Surgery in Preventing Postoperative Epiretinal Membrane (ERM) Formation. Pak J Med Sci. 2021;37(3):---------. doi: https://doi.org/10.12669/pjms.37.3.3576 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Open Globe Injury in a Tertiary Care Hospital

2018 ◽  
Vol 16 (2) ◽  
pp. 62-65
Author(s):  
Bikram Bahadur Thapa ◽  
Dabal Bahadur Thapa ◽  
Har Karan Nath
Keyword(s):  
Visual Acuity ◽  
Primary Repair ◽  
Tertiary Care ◽  
College Teaching ◽  
Posterior Segment ◽  
Care Hospital ◽  
Open Globe Injury ◽  
Young Males ◽  
Medical College ◽  
Open Globe

Introduction: Open Globe Injury (OGI) is a type of mechanical eye injury in which there is a full thickness defect of the outer fibrous coat of eye ball. The Prognosis in the eyes with OGI has improved in these days. 2.4% of blindness in Nepal was due to ocular trauma in 1981. The aim of this study was to describe epidemiological profile, clinical profile and treatment outcome in eyes with open globe injury. Methodology: It is the prospective interventional non randomized hospital based study on the patients of open globe injury presented to the Nepalgunj Medical College, Nepalgunj from April 2017 to May 2018. Visual acuity, anterior and posterior segment evaluation, site and size of wound were recorded. All the eyes were underwent primary repair surgery. Postoperative visual acuity, anterior and posterior segment evaluation was carried out on all follow up. Second surgery was done if required. Results: 0.4% of ophthalmic and 0.016% of all hospital patients had open globe injury. Most of the victims were young males. The mean age of study population was 10.98±17.1 year. Playing (62.5%) was the most common time of injury and wooden stick (50%) was most common agent of injury. Zone I involvement (87.5%) and penetrating type (91.7%) was found in most of cases. 87.5% of eyes were blind, 4.2%were visually impaired and 8.3% had normal vision at the time of presentation. 79.2 % of eye were improved after treatment on visual function, 12.5% remained unchanged while 8.3% deteriorates and leads to pthysis bulbi. Conclusion: The incidence of open globe injury was 0.4% among ophthalmic patients and 0.016% among all patients of Nepalgunj Medical College Teaching Hospital, Nepalgunj. Early Primary repair, use of systemic antibiotics and postoperative care provides encouraging anatomical and functional outcome in these eyes with OGI.

scholarly journals Reconstructing Foveola by Foveolar Internal Limiting Membrane Non-Peeling and Tissue Repositioning for Lamellar Hole-Related Epiretinal Proliferation

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Tzyy-Chang Ho ◽  
Allen Yi-Lun Ho ◽  
Muh-Shy Chen
Keyword(s):  
Visual Acuity ◽  
Clinical Characteristics ◽  
Internal Limiting Membrane ◽  
Lamellar Macular Hole ◽  
Ilm Peeling ◽  
Corrected Visual Acuity ◽  
Tangential Traction ◽  
Group 2 ◽  
Lamellar Hole ◽  
Group 1

Abstract Differences in the pathogenesis and clinical characteristics between lamellar macular hole (LMH) with and without LMH-associated epiretinal proliferation (LHEP) can have surgical implications. This study investigated the effects of treating LHEP by foveolar internal limiting membrane (ILM) non-peeling and epiretinal proliferative (EP) tissue repositioning on visual acuity and foveolar architecture. Consecutive patients with LHEP treated at our institution were enrolled. The eyes were divided into a conventional total ILM peeling group (group 1, n = 11) and a foveolar ILM non-peeling group (group 2, n = 22). In group 2, a doughnut-shaped ILM was peeled, leaving a 400-μm-diameter ILM without elevated margin over the foveola after EP tissue repositioning. The EP tissue was elevated, trimmed, and inverted into the LMH. Postoperatively, the LMH was sealed in all eyes in group 2, with significantly better best-corrected visual acuity (−0.26 vs −0.10 logMAR; p = 0.002). A smaller retinal defect (p = 0.003), a more restored ellipsoid zone (p = 0.002), and a more smooth foveal depression (p < 0.001) were achieved in group 2. Foveolar ILM non-peeling and EP tissue repositioning sealed the LMH, released the tangential traction, and achieved better visual acuity. The presumed foveolar architecture may be reconstructed surgically. LMH with LHEP could have a combined degenerative and tractional mechanism.

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 ◽  
...  
Keyword(s):  
Visual Field ◽  
Epiretinal Membrane ◽  
Pars Plana Vitrectomy ◽  
Internal Limiting Membrane ◽  
Visual Field Defects ◽  
Automated Perimetry ◽  
Standard Automated Perimetry ◽  
Ilm Peeling ◽  
Idiopathic Epiretinal Membrane ◽  
Pars Plana

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.

scholarly journals Adjacent-Level Ossification Development in Single-Level Standalone Anterior Cervical Discectomy and Fusion Versus Anterior Cervical Discectomy and Fusion With Plate

2020 ◽  
pp. 219256822090274
Author(s):  
Christopher Huang ◽  
Ralph Mobbs ◽  
Michael Selby ◽  
Kevin Phan ◽  
Prashanth Rao
Keyword(s):  
Confidence Interval ◽  
Odds Ratio ◽  
Case Control Study ◽  
Case Control ◽  
Anterior Cervical Discectomy ◽  
Adjacent Level ◽  
Retrospective Case ◽  
Cervical Discectomy ◽  
Surgical Data ◽  
Control Study

Study Design: Retrospective case control study. Objectives: Adjacent-level ossification development (ALOD) is a distinct form of adjacent segmental degeneration that has been recognized to occur after anterior cervical discectomy and fusion (ACDF). It is unclear whether ACDF with plate versus standalone has an effect on rates of ALOD. This retrospective case-control study aims to assess the rate of ALOD in a large series of patients undergoing ACDF with and without plate and factors causing ALOD. Methods: Data was collected for patients undergoing ACDF from January 2009 to July 2016. Data collected was from multiple centers and included demographic data, surgical data, radiological imaging at time of surgery, and serial follow-up imaging. The radiology for ALOD was independently reviewed. Cohorts were divided into ACDF with plate (Group P = plate) and ACDF without plate (Groups S = standalone) and outcomes were compared. Results: There were 260 patients with 138 (53%) in Group P and 122 (47%) in Group S. ALOD was observed in 15.3% of patients overall, 29% in group P and 2.8% in group S ( P < .001). Following multivariate adjustment, statistically significant association was found between use of plate and ALOD (odds ratio = 12.8, 95% confidence interval = 3.52-45.45, P < .001). Plate-to-disc distance <5 mm was significantly associated with ALOD (odds ratio = 13.5, 95% confidence interval = 3.83-47.62, P < .001). Conclusion: The use of anterior plate with ACDF was associated with ALOD. Plate-to-disc distance <5 mm was significantly associated with ALOD even after adjustment for confounding factors. We conclude utilization of standalone cages or cages with plate with more than 5 mm distance from adjacent disc to minimize ALOD.

scholarly journals Efficacy of 27-Gauge Vitrectomy with Internal Limiting Membrane Peeling for Epiretinal Membrane in Glaucoma Patients

2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Masaaki Yoshida ◽  
Hiroshi Kunikata ◽  
Shiho Kunimatsu-Sanuki ◽  
Toru Nakazawa
Keyword(s):  
Visual Acuity ◽  
Visual Field ◽  
Epiretinal Membrane ◽  
Internal Limiting Membrane ◽  
Threshold Sensitivity ◽  
Mean Deviation ◽  
Normal Test ◽  
Microincision Vitrectomy Surgery ◽  
Test Points

Purpose. To evaluate the efficacy of epiretinal membrane (ERM) surgery for patients with ERM and glaucoma. Methods. We reviewed the medical records of 20 consecutive ERM patients with glaucoma, who underwent 27-gauge microincision vitrectomy surgery (27GMIVS) with internal limiting membrane (ILM) peeling. The preoperative and 6-month postoperative visual field was tested with the Humphrey Field Analyzer (HFA) 24-2 program. Changes in threshold sensitivity in the HFA test points were analyzed point-by-point, with points classified into groups based on sensitivity as abnormal (less than 5th percentile in pattern deviation) or normal (all other points) and based on location as central (12 central points) or peripheral (all other points) with a linear mixed-effects model. Results. Visual acuity and mean deviation improved postoperatively (P<0.001 for both) in all patients. Threshold sensitivity in central or peripheral points that were abnormal preoperatively improved postoperatively (P=0.006 or P<0.001, respectively). Threshold sensitivity also improved in the central normal test points (P=0.03), but not in the peripheral normal points (P=0.12). Conclusion. Visual acuity improved, and there was no visual field progression, after ERM surgery in glaucomatous eyes during a 6-month postoperative follow-up, suggesting that ERM and ILM removal using 27GMIVS may be effective even in glaucomatous eyes.

Current status of eye disorders caused by docetaxel administration every 3 weeks: A case-control study in Japanese patients

2019 ◽  
Vol 26 (3) ◽  
pp. 655-665 ◽  
Author(s):  
Yusuke Noguchi ◽  
Yugo Kawashima ◽  
Megumi Maruyama ◽  
Hiroko Kawara ◽  
Yoko Tokuyama ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Case Control Study ◽  
Japanese Patients ◽  
Case Control ◽  
Current Status ◽  
Eye Drops ◽  
Eye Disorders ◽  
Control Study

Purpose Docetaxel is known to cause eye disorders. In this study, current status of eye disorders caused by docetaxel administration every 3 weeks in Japanese patients was examined. Methods This case-control study targeted patients who were newly administered docetaxel at the Kyoto Okamoto Memorial Hospital between 1 July 2015 and 30 June 2018. Eye disorder occurrence was defined as an event in which the pharmacist confirmed the symptoms in a patient interview and the ophthalmologist diagnosed the disorder. Results Of the 89 subjects, 7 (7.9%) had eye disorders. The symptoms were watering eyes (7.9%), a stye and eye discharge (2.2% each), corneal and conjunctival disorder, visual acuity reduction, and blepharedema (1.1% each). Four patients who presented with watering eyes, eye discharge, or corneal and conjunctival disorder showed improvement with the use of eye drops such as artificial tears. Two patients who presented with a stye showed improvement with the use of oral cefcapene. One patient with mild symptoms showed spontaneous improvement. However, one patient had irreversible visual acuity reduction. The multivariate logistic regression analysis revealed that a cumulative docetaxel dose of ≥300 mg/m2 (odds ratio: 15.50, 95% confidence interval: 1.37–175.00, p = 0.027) and concomitant cyclophosphamide use (odds ratio: 13.20, 95% confidence interval: 1.13–153.00, p = 0.039) were significant risk factors associated with eye disorders. Conclusion In conclusion, it was determined that docetaxel-related eye disorders might be influenced by the cumulative dose of docetaxel and concomitant cyclophosphamide use. In addition, relatively mild symptoms improved with medication.

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