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.

Effects of internal limiting membrane peeling during vitrectomy for macula-off primary rhegmatogenous retinal detachment

2018 ◽  
Vol 28 (6) ◽  
pp. 706-713 ◽  
Author(s):  
María José Blanco-Teijeiro ◽  
Manuel Bande Rodriguez ◽  
Raquel Mansilla Cuñarro ◽  
Laura Paniagua Fernández ◽  
Francisco Ruiz-Oliva Ruiz ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Epiretinal Membrane ◽  
Rhegmatogenous Retinal Detachment ◽  
Internal Limiting Membrane ◽  
Postoperative Recovery ◽  
Membrane Formation ◽  
Internal Limiting Membrane Peeling ◽  
Membrane Peeling ◽  
Visual Outcomes ◽  
Retinal Breaks

Purpose: To determine the effectiveness of internal limiting membrane peeling during vitrectomy for macula-off primary rhegmatogenous retinal detachment in the prevention of postoperative epiretinal membrane formation and achievement of good visual outcomes and to identify preoperative and intraoperative risk factors for epiretinal membrane formation. Methods: We retrospectively analyzed data from 62 eyes of 62 consecutive patients with macula-off primary rhegmatogenous retinal detachment who underwent vitrectomy with (n = 30) or without (n = 32) internal limiting membrane peeling between January 2014 and March 2016 and were followed up for at least 12 months. The effects of internal limiting membrane peeling on visual outcomes and postoperative recovery of the macular structure were determined. We subsequently divided patients into an epiretinal membrane group and a non-epiretinal membrane group and assessed the effects of various preoperative and intraoperative factors on postoperative epiretinal membrane formation. Results: Postoperative epiretinal membrane developed in 10 patients in the no internal limiting membrane peeling group and three patients in the internal limiting membrane peeling group. Postoperative visual acuity significantly improved in both groups. Epiretinal membrane formation was found to be correlated with a higher number of retinal breaks. Conclusion: Our results suggest that internal limiting membrane peeling during macula-off primary rhegmatogenous retinal detachment surgery can reduce the occurrence of postoperative epiretinal membrane, is safe, and results in favorable visual outcomes.

scholarly journals Internal Limiting Membrane Flap in the Management of Retinal Detachment due to Paracentral Retinal Breaks

2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Yen-Chih Chen ◽  
Chung-May Yang ◽  
San-Ni Chen
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Structural Changes ◽  
Rhegmatogenous Retinal Detachment ◽  
Case Series ◽  
Major Complication ◽  
Internal Limiting Membrane ◽  
Fluid Exchange ◽  
Membrane Peeling ◽  
Retinal Breaks

Purpose. To describe the technique and outcomes of using either inverted or free internal limiting membrane flap in the management of retinal detachment due to paracentral retinal breaks. Methods. This retrospective observational case series includes nine patients who received surgery for retinal detachment due to paracentral retinal breaks developed either from primary rhegmatogenous origin, or secondary iatrogenic retinal breaks after prior membrane peeling, or during surgery for tractional retinal detachment. Either inverted or free internal limiting membrane flaps were inserted in the identified breaks, followed by air fluid exchange and gas tamponade. Visual acuity and structural changes were evaluated. Results. Nine eyes were included. One had primary rhegmatogenous retinal detachment, one had highly myopic eye with peripapillary atrophic hole, three had secondary retinal detachment after membrane peeling for foveoschisis or macular pucker, one had recurrent retinal detachment due to proliferative vitreoretinopathy, one had combination of tractional and rhegmatogenous retinal detachment, and two had iatrogenic breaks during surgery. The retinal breaks of all eyes were sealed with retina attached postoperatively. Visual acuity in logarithm of minimal angle of resolution improved from 1.18 ± 0.55 preoperatively to 0.74 ± 0.47 postoperatively (p=0.04). Conclusion. Internal limiting membrane flap technique can be a surgical approach selectively for retinal detachment due to paracentral retinal breaks with difficulty for laser application. The retina can be attached successfully and achieve good visual outcome without major complication. This trial is registered with NCT03707015.

scholarly journals Analysis of Changes in Corneal Topography after 27-Gauge Transconjunctival Microincision Vitrectomy Combined with Cataract Surgery

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Tomoyuki Watanabe ◽  
Tamaki Gekka ◽  
Akira Watanabe ◽  
Tadashi Nakano
Keyword(s):  
Intraocular Pressure ◽  
Retinal Detachment ◽  
Cataract Surgery ◽  
Macular Hole ◽  
Epiretinal Membrane ◽  
Rhegmatogenous Retinal Detachment ◽  
Corneal Topography ◽  
High Order ◽  
Before And After ◽  
Port System

Purpose. To investigate changes in the corneal shape before and after vitrectomy, over a period of time, using a 27-gauge system. Methods. Forty-five eyes underwent a combination of cataract surgery and vitrectomy. The surgeries were performed using a 27-gauge transconjunctival vitrectomy system, in which the corneal topography could be performed up to three months after the surgery. The surgeries were performed for an epiretinal membrane in 11 eyes, a macular hole in 14 eyes, and rhegmatogenous retinal detachment in 20 eyes. All of the surgeries were performed by the same surgeon, and in all cases, a 4-port 27-gauge vitrectomy device was used. Cataract surgery in all patients was performed with a 2.4 mm corneoscleral incision at 11 o’clock. The surgeries were performed without suturing the operative wound in all cases. Corneal topography was performed using a TMS-4 topographer (Tomey Corporation, Tokyo, Japan). The examinations were performed the day before and 1 day, 1 week, 1 month, and 3 months after the surgery. The results of corneal topography for the spherical, regular astigmatic, asymmetric, and high-order irregular astigmatic components were compared before and after surgery. Results. No significant differences were seen in any of the components in the epiretinal membrane group, but significant differences were seen in the asymmetric components and the high-order irregular astigmatic components between the macular hole and rhegmatogenous retinal detachment groups (p<0.05). There were no significant changes in intraocular pressure on any measurement time in the postoperative period compared to preoperative intraocular pressure. Conclusion. Irregular astigmatism was seen after surgery when 27-gauge vitrectomy with a 4-port system was performed together with cataract surgery with a 2.4 mm incision.

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

2019 ◽  
pp. bjophthalmol-2019-315095 ◽  
Author(s):  
Vinod Kumar ◽  
Devashish Dubey ◽  
Devesh Kumawat ◽  
Ashish Markan ◽  
Parijat Chandra ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Epiretinal Membrane ◽  
Conventional Treatment ◽  
Statistical Difference ◽  
Randomised Trial ◽  
Internal Limiting Membrane ◽  
Ilm Peeling ◽  
Group 2

AimTo study the role of internal limiting membrane (ILM) peeling in the prevention of macular epiretinal membrane (ERM) formation following pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RRD).MethodsIn a randomised trial, patients with macula-off RRD (duration ≤3 months) with proliferative vitreoretinopathy grade ≤C1 and absence of pre-existing maculopathy were recruited from June 2016 to May 2018. Patients were randomised into two groups: group 1 (conventional treatment) underwent PPV alone, while group 2 underwent PPV with macular ILM peeling. The main outcome measures were macular ERM formation (detected on optical coherence tomography), corrected distance visual acuity (CDVA), retinal attachment and central macular thickness (CMT) at last follow-up (minimum 6 months).ResultsSixty patients (30 in each group) completed the required follow-up. The two groups were comparable in sex distribution, age, duration of RRD, baseline CDVA and duration of follow-up (median 15.5 vs 14 months). Macular ERM developed in 20% (n=6) and 0% of eyes in groups 1 and 2, respectively (p=0.002). Retinal reattachment was attained in all eyes. There was no statistical difference in final CDVA between the groups (p=0.43). Dissociated optic nerve fibre layer (DONFL) was found in 0% and 40% (n=12) of eyes in groups 1 and 2, respectively (p=0.0001). However, DONFL did not significantly affect the final CDVA (p=0.84). The final CMT was 266.0±37.5 µm and 270.0±73.7 µm in groups 1 and 2, respectively, with no statistical difference (p=0.62).ConclusionsILM peeling prevents macular ERM formation following PPV for RRD but provides similar visual outcomes as compared with conventional treatment.Trial registration numberCTRI2018/04/012978.

Implantation of multifocal lens in cataract surgery in patients after vitreoretinal surgery

2021 ◽  
pp. 10-12
Author(s):  
U.R. Altynbaev ◽  
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Cataract Surgery ◽  
Macular Hole ◽  
Epiretinal Membrane ◽  
Vitreoretinal Surgery ◽  
Long Distance ◽  
Uncorrected Visual Acuity ◽  
Lens Implantation ◽  
Multifocal Lens

Purpose. To study the results of cataract surgery with implantation of multifocal IOLs in patients with various retinal pathologies who underwent vitreoretinal surgery. Material and мethods. Fifteen patients who had previously undergone vitreoretinal interventions for macular hole (n=6), epiretinal membrane (n=4) and retinal detachment (n=5) were observed. The criterion for choosing in favor of multifocal lens implantation was high visual acuity (0.7 or more) after undergoing vitreoretinal surgery. All patients underwent cataract phacoemulsification with implantation of two types of multifocal lenses: I group – IOL with an extended near focus (EDOF) (n=8) and II group – with a multifocal three-focus lens (n=7 eyes), including, in 3 cases – with toric component. In 55% of cases, the operation was performed on both eyes. The age of the patients varied from 34 to 59 years (51.4 ± 6.1 years). Results. Long-distance uncorrected visual acuity varied from 0.7 to 1.0 (0.85±0.25), which did not depend on the type of intraocular lens and correlated with morphological changes in the macular region of the retina. The highest uncorrected visual acuity (0.8±0.14) at an intermediate and near distance (0.75±0.25) was achieved in I group of patients. Postoperative spherical equivalent after 1 month corresponded to the planned target refraction (Em±0.5 diopters) in 14 cases and remained stable during 12 months of observation. In general, subjective satisfaction with MIOL implantation was higher in patients in II group, which was explained by minimal changes in the macular region of the retina. Additional spectacle correction for near was required for a patient of I group with a history of macular rupture, who underwent bilateral multifocal IOL implantation with high uncorrected visual acuity in the distance (OD=1.0 \ OS=1.0) and near (OD=0.6 \ OS=0,5). Conclusion. Implantation of multifocal lenses in patients with a good anatomical and functional outcome of vitreoretinal surgery allows obtaining high and stable functional results. Bilateral implantation of a multifocal lens with an extended near focus in patients with operated macular pathology does not cause specific adaptive difficulties in binocular vision. The choice in favor of multifocal lens implantation in patients with vitreoretinal pathology requires an individual approach and careful selection. Key words: multifocal lens, cataract, macular hole, retinal detachment, epiretinal membrane.

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