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Martens RK, Chen C, Ehmann DS, Greve M, Seamone ME. Effect of Macular Internal Limiting Membrane Peeling on Single Surgery Success Rates of Vitrectomy for Uncomplicated, Primary Macula-Off Retinal Detachment. JOURNAL OF VITREORETINAL DISEASES 2023; 7:193-198. [PMID: 37181757 PMCID: PMC10170614 DOI: 10.1177/24741264231155352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Purpose: To determine the anatomic and visual outcomes of pars plana vitrectomy for uncomplicated, primary macula-off rhegmatogenous retinal detachment (RRD) with and without internal limiting membrane (ILM) peeling. Methods: This retrospective chart review comprised 129 patients with uncomplicated, primary macula-off RRD presenting between January 1, 2016, and May 31, 2021. Thirty-six patients (27.9%) had ILM peeling and 93 (72.0%) did not. The primary outcome was the rate of recurrent RRD. Secondary outcomes included preoperative and postoperative best-corrected visual acuity (BCVA), epiretinal membrane (ERM) formation, and macular thickness. Results: No significant difference was found in the risk for recurrent RRD between patients who had ILM peeling and those who did not (2.8% [1/36] and 5.4% [5/93], respectively) (P = 1.00). The final postoperative BCVA was better in eyes that did not have ILM peeling (P< .001). No ERM occurred in the group with ILM peeling, whereas ERM occurred in 27 patients (29.0%) who did not have ILM peeling. The temporal macular retina was thinner in eyes in which ILM peeling was performed. Conclusions: The risk for recurrent RRD was not statistically lower in eyes having ILM peeling of the macula in uncomplicated, primary macula-off RRD. Despite a reduction in postoperative ERM formation, eyes having macular ILM peeling had worse postoperative VA.
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Affiliation(s)
- Rosanna K. Martens
- Department of Ophthalmology and Visual Sciences, University of Alberta, Edmonton, AB, Canada
- Rosanna K. Martens, MD, Department of Ophthalmology and Visual Sciences, University of Alberta, 10924 107 Ave, Ste 400, Edmonton, AB T5H 0X5, Canada.
| | - Chao Chen
- Department of Ophthalmology and Visual Sciences, University of Alberta, Edmonton, AB, Canada
| | - David S. Ehmann
- Department of Ophthalmology and Visual Sciences, University of Alberta, Edmonton, AB, Canada
| | - Mark Greve
- Department of Ophthalmology and Visual Sciences, University of Alberta, Edmonton, AB, Canada
| | - Mark E. Seamone
- Department of Ophthalmology and Visual Sciences, University of Alberta, Edmonton, AB, Canada
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Zhang B, Dong X, Sun Y. Effect of internal limiting membrane peeling for idiopathic epiretinal membrane. Heliyon 2023; 9:e14079. [PMID: 36915505 PMCID: PMC10006490 DOI: 10.1016/j.heliyon.2023.e14079] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 02/18/2023] [Accepted: 02/20/2023] [Indexed: 03/06/2023] Open
Abstract
Purpose To further evaluate the necessity of internal limiting membrane (ILM) peeling for patients with idiopathic epiretinal membrane (iERM). Method We searched PubMed, Web of Science, Embase, Cochrane Library, and CNKI from their inception up to August 24, 2021. Eligible meta-analyses comparing iERM removal with and without ILM peeling were included. AMSTAR and GRADE classification was used to assess the methodological quality of each study and the quality for each outcome, respectively. The primary outcomes were best-corrected visual acuity (BCVA), central macular thickness (CMT), and recurrence. Results 10 meta-analyses were included. 75.9% of studies revealed no statistically significant difference in BCVA between the groups, while only 10.3% showed better BCVA favorable to additional ILM peeling. 54.2% reported no significant difference in CMT between the groups, followed by 41.7% showing thicker CMT due to additional ILM peeling. Compared to iERM removal alone, additional ILM peeling provided a lower recurrence rate in 66.7% of studies. Conclusion ILM peeling could significantly reduce recurrence rate, but not significantly improve the recovery of visual outcome or decrease the thickness of central macula.
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Affiliation(s)
- Bowen Zhang
- Surgical Department, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - Xingmei Dong
- Department of Pathology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou 510120, China
| | - Yi Sun
- Department of Ophthalmology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
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Corvi F, Viola F, Germinetti F, Parrulli S, Zicarelli F, Bottoni F, deAngelis S, Milella P, Cereda MG. Functional and anatomic changes between early postoperative recovery and long-term follow-up after combined epiretinal and internal limiting membrane peeling. CANADIAN JOURNAL OF OPHTHALMOLOGY 2023; 58:52-58. [PMID: 34343483 DOI: 10.1016/j.jcjo.2021.06.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 03/31/2021] [Accepted: 06/27/2021] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To evaluate short- and long-term changes in best-corrected visual acuity (BCVA) and retinal layer thicknesses after combined epiretinal membrane (ERM) and internal limiting membrane (ILM) peeling for macular holes and symptomatic ERMs. DESIGN Retrospective observational case series. PARTICIPANTS Patients with ERMs or with macular holes and ERMs treated with combined ERM and ILM peeling. METHODS Study eyes (n = 36) and healthy fellow eyes (n = 17) were evaluated using the automated segmentation of retinal layers performed by SPECTRALIS software that automatically calculated the average central retinal thickness and the average thickness in each of the individual retinal layers. The analysis was performed at 6-18 months after surgery and after 60 months. MAIN OUTCOME MEASURES Changes in BCVA and retinal layer thicknesses determined by automated segmentation at the first and last follow-up visits. RESULTS BCVA improved from a baseline 0.48 ± 0.25 logMAR (20/60 Snellen) to 0.18 ± 0.18 logMAR (20/30 Snellen) at the short-term postoperative examination (p < 0.0001). Between first and last follow-up visit, 5 eyes (14%) were classified as better, 28 (78%) as stable, and 3 (8%) as worse. BCVA of the control fellow eyes remained stable during the follow-up. The thicknesses of retinal layers decreased significantly (p < 0.009). At the last follow-up, the ganglion cell layer was thinner and the inner nuclear layer was thicker in the operated eyes compared with the healthy fellow eyes. CONCLUSION Combined ERM and ILM peeling may improve BCVA in some patients. However, over a long follow-up period, it can be associated with progressive ganglion cell layer thinning that could affect BCVA stability.
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Affiliation(s)
- Federico Corvi
- Eye Clinic, Department of Biomedical and Clinical Sciences, "Luigi Sacco" Hospital, University of Milan, Milan, Italy.
| | - Francesco Viola
- Cà Granda Foundation, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Francesco Germinetti
- Cà Granda Foundation, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Salvatore Parrulli
- Eye Clinic, Department of Biomedical and Clinical Sciences, "Luigi Sacco" Hospital, University of Milan, Milan, Italy
| | - Federico Zicarelli
- Eye Clinic, Department of Biomedical and Clinical Sciences, "Luigi Sacco" Hospital, University of Milan, Milan, Italy
| | - Ferdinando Bottoni
- Eye Clinic, Department of Biomedical and Clinical Sciences, "Luigi Sacco" Hospital, University of Milan, Milan, Italy
| | - Stefano deAngelis
- Eye Clinic, Department of Biomedical and Clinical Sciences, "Luigi Sacco" Hospital, University of Milan, Milan, Italy
| | - Paolo Milella
- Cà Granda Foundation, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Matteo Giuseppe Cereda
- Eye Clinic, Department of Biomedical and Clinical Sciences, "Luigi Sacco" Hospital, University of Milan, Milan, Italy
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Ishida Y, Tsuboi K, Wakabayashi T, Baba K, Kamei M. En Face OCT Detects Preretinal Abnormal Tissues Before and After Internal Limiting Membrane Peeling in Eyes with Macular Hole. Ophthalmol Retina 2023; 7:153-163. [PMID: 35987293 DOI: 10.1016/j.oret.2022.08.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 07/25/2022] [Accepted: 08/11/2022] [Indexed: 02/06/2023]
Abstract
PURPOSE To assess preretinal abnormal tissue (PAT) using en face OCT in eyes with idiopathic macular holes (MHs). DESIGN Retrospective, observational study. PARTICIPANTS Patients with MH who received 6 × 6-mm spectral-domain-OCT scans. METHODS Preretinal abnormal tissue was detected by en face OCT images with a custom slab, defined with an anterior boundary of 6 μm anterior to the internal limiting membrane (ILM) and a posterior boundary at 3 μm posterior to the ILM. The PAT was defined as any abnormal tissues observed in en face OCT. MAIN OUTCOME MEASURES Characteristics of preoperative and postoperative PAT. RESULTS Sixty eyes with MH from 60 patients were included. Fifty-one eyes underwent preoperative analysis, and 46 eyes underwent postoperative examination. Before surgery, 48 (94%) eyes had a mean (standard deviation [SD]) PAT of 6.6 (9.8) mm2. The corresponding cross-sectional OCT showed PAT consisting of epiretinal proliferation, epivascular glia, and a preretinal hyperreflective band. Preretinal abnormal tissue was contiguous to the hole (peri-MH PAT) in 12 eyes (24%), whereas others (36 eyes, 76%) had a scattered distribution (extrafoveal PAT). The area of PAT was greater in eyes with a peri-MH PAT than in eyes with an extrafoveal PAT (P < 0.0001). Compared to the eyes with the extrafoveal PAT, the eyes with the peri-MH PAT were associated with men (P = 0.0059) and worse baseline visual acuity (VA) (P = 0.0002). In eyes with ILM peeling (42 eyes), postoperative PAT proliferation was observed from the edge of the ILM peeling toward the periphery over a 1-year follow-up. The mean (SD) area of PAT at 2 weeks after surgery was 3.4 (3.6) mm2 and increased to 12.1 (6.4) mm2 at 12 months (P < 0.0001). However, no PAT increase was observed in 4 eyes that underwent vitrectomy without ILM peeling. The postoperative PAT size was not associated with the postoperative VA. CONCLUSIONS En face OCT revealed PAT in most eyes with MHs. Peri-MH PAT was associated with worse VA and was seen more frequently in male patients. Postoperative PAT proliferation may be triggered by ILM peeling, but it is not associated with worse VA.
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Affiliation(s)
- Yuichiro Ishida
- Department of Ophthalmology, Aichi Medical University, Nagakute, Aichi, Japan
| | - Kotaro Tsuboi
- Department of Ophthalmology, Aichi Medical University, Nagakute, Aichi, Japan; Casey Eye Institute, Oregon Health & Science University, Portland, Oregon.
| | - Taku Wakabayashi
- Mid Atlantic Retina, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania; Department of Ophthalmology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Keita Baba
- Department of Ophthalmology, Aichi Medical University, Nagakute, Aichi, Japan
| | - Motohiro Kamei
- Department of Ophthalmology, Aichi Medical University, Nagakute, Aichi, Japan
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Jun SY, Hwang DDJ. Effect of vitrectomy with silicone oil tamponade and internal limiting membrane peeling on eyes with proliferative diabetic retinopathy. Sci Rep 2022; 12:8076. [PMID: 35577870 PMCID: PMC9110348 DOI: 10.1038/s41598-022-12113-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 04/05/2022] [Indexed: 11/15/2022] Open
Abstract
We investigated the combined effect of silicone tamponade and the internal limiting membrane (ILM) peeling and investigated whether timing of peeling of the ILM affects the outcomes of vitrectomy with silicone oil tamponade in eyes with proliferative diabetic retinopathy (PDR). Here, we examined 63 eyes (58 patients) with PDR, which underwent vitrectomy with silicone oil tamponade and stepwise removal of silicone oil. ILM peeling was performed just before oil injection (group 1; 33 eyes, 30 patients) or after oil removal (group 2; 30 eyes, 28 patients). Visual acuity and retinal and choroidal thicknesses were compared between the groups. Thinning of the inner retina, including the ganglion cell-inner plexiform layer and macular retinal nerve fiber layer, was evident at 1 year after surgery in both groups. Thinning of the total retina (P = 0.019) and inner retina (P = 0.008) was significantly correlated with final visual acuity. There was no considerable between-group difference observed in final visual acuity, intraocular pressure, or retinal or choroidal thickness at 1 year after surgery. The incidence of epiretinal membrane was higher during silicone endo-tamponade in group 2 (P = 0.033). Visual recovery and macular configuration in eyes with PDR are not affected by whether the ILM is peeled before or after silicone oil tamponade.
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Affiliation(s)
- Sung Yeon Jun
- Department of Ophthalmology, Hangil Eye Hospital, 35 Bupyeong-daero, Bupyeong-gu, Incheon, 21388, South Korea
| | - Daniel Duck-Jin Hwang
- Department of Ophthalmology, Hangil Eye Hospital, 35 Bupyeong-daero, Bupyeong-gu, Incheon, 21388, South Korea. .,Department of Ophthalmology, Catholic Kwandong University College of Medicine, Incheon, South Korea.
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Sun Y, Zhou R, Zhang B. WITH OR WITHOUT INTERNAL LIMITING MEMBRANE PEELING FOR IDIOPATHIC EPIRETINAL MEMBRANE: A Meta-Analysis of Randomized Controlled Trials. Retina 2021; 41:1644-1651. [PMID: 33394964 DOI: 10.1097/iae.0000000000003076] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To clarify whether internal limiting membrane (ILM) peeling provides better outcomes for patients with idiopathic epiretinal membrane. METHODS Randomized controlled trials comparing epiretinal membrane removal with and without ILM peeling were searched in Embase, PubMed, Web of Science, Cochrane Library, and CNKI before April 15, 2020. The pooled mean difference (MD) for best-corrected visual acuity, central macular thickness, and odds ratio for recurrence were calculated. RESULTS Eight randomized controlled trials involving 422 eyes were included. No significant difference in best-corrected visual acuity (final follow-up: MD, 0.03 logarithm of the minimum angle of resolution [1.5 Early Treatment Diabetic Retinopathy Study letters]; 95% confidence interval [CI], -0.04 to 0.09 [-4.5 to 2 Early Treatment Diabetic Retinopathy Study letters]; P = 0.40) or recurrence rate (odds ratio, 0.21; 95% CI, 0.04-1.05; P = 0.06) between the groups was observed. However, patients with ILM peeling presented thicker central macular thickness at 3 months (MD, 16.36; 95% CI, 1.26-31.46; P = 0.03), 6 months (MD, 22.64; 95% CI, 10.29-34.98; P = 0.0003) and the final follow-up (MD, 25.87; 95% CI, 13.96-37.79; P < 0.0001). CONCLUSION The study showed that ILM peeling did not significantly improve the postoperative visual outcome or decrease recurrence, but result in thicker central macular thickness, indicating that it is inessential for idiopathic epiretinal membrane.
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Affiliation(s)
- Yi Sun
- Department of Ophthalmology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Rouxi Zhou
- Department of Ophthalmology, Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, Hunan, China; and
| | - Bowen Zhang
- Surgical Department, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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7
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Han GH, Han DJ, Lee JH, Byeon SH, Shin JY. Tomographic Structural Changes of the Inner Retina after Internal Limiting Membrane Peeling for Idiopathic Epiretinal Membrane. KOREAN JOURNAL OF OPHTHALMOLOGY 2021; 34:235-241. [PMID: 32495532 PMCID: PMC7269741 DOI: 10.3341/kjo.2019.0126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 01/10/2020] [Accepted: 03/11/2020] [Indexed: 11/25/2022] Open
Abstract
Purpose To investigate the tomographic structural changes in the retinal layers after internal limiting membrane (ILM) peeling for idiopathic epiretinal membrane (ERM). Methods Sixty-nine eyes treated with vitrectomy and ILM peeling for idiopathic ERM were analyzed. Parafoveal retinal thickness was measured at baseline and 6 months after surgery. Results Total retinal thickness decreased significantly in the nasal and temporal subfields after surgery (p < 0.001), whereas the inner nuclear layer and outer nuclear layer showed nasal thickening (all, p < 0.001). The postoperative temporal/nasal subfield thickness ratio of each layer was significantly lower than that of fellow eyes. Eyes with larger ILM peeling showed a significantly lower temporal/nasal subfield thickness ratio (p = 0.033) than those with smaller sizes. Conclusions The retinal thickness of each layer showed anatomical changes from ILM peeling and ERM removal. Nasal parafoveal thickening and temporal thinning occurred in the inner retinal architecture, which might be affected by ILM peeling size.
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Affiliation(s)
- Ga Hee Han
- Department of Ophthalmology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Dong Jin Han
- Department of Ophthalmology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Jong Hyun Lee
- Department of Ophthalmology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Suk Ho Byeon
- Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea
| | - Joo Youn Shin
- Department of Ophthalmology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea.,Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea.
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8
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Takeyama A, Imamura Y, Shibata M, Komiya Y, Ishida M. Inner retinal structure and visual function after idiopathic epiretinal membrane surgery with and without brilliant blue G. Jpn J Ophthalmol 2021; 65:689-697. [PMID: 34196835 DOI: 10.1007/s10384-021-00851-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 05/28/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE Vital dyes are frequently used to visualize the internal limiting membrane (ILM) of the neuroretina. This study evaluated and compared the microstructure of the inner retina and visual function with and without brilliant blue G (BBG) staining for ILM peeling during idiopathic epiretinal membrane (ERM) surgery. STUDY DESIGN Retrospective, consecutive, interventional case series. METHODS Fifty-five patients (55 eyes) with ERM underwent ILM peeling without dyes (non-dye group) and 55 patients (55 eyes) underwent ILM peeling with BBG staining (BBG group). The logMAR visual acuity (VA) and ganglion cell complex (GCC) thickness were measured using optical coherence tomography at baseline and 12 months after surgery. RESULTS LogMAR VA improved significantly in both groups at 12 months and the BBG group tended to be better than the non-dye group but with no significant difference between the groups (unpaired t-test, P = 0.490). The average GCC thickness significantly decreased in both groups; however, there was no difference in the rates of change in GCC thickness between the groups. The ratio of GCC thickness to total retinal thickness (%) was significantly higher in the BBG group in the superior quadrant at 12 months postoperatively (P = 0.010). CONCLUSION BBG-assisted ERM surgery resulted in better visual improvement and fewer structural changes in the inner retinal layers. BBG-assisted ILM peeling is safe both functionally and anatomically.
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Affiliation(s)
- Asuka Takeyama
- Department of Ophthalmology, Teikyo University School of Medicine, University Hospital Mizonokuchi, 5-1-1Takatsu-ku, FutagoKawasaki, Kanagawa, 213-8507, Japan. .,Department of Ophthalmology, Toho University Ohashi Medical Center, Tokyo, Japan.
| | - Yutaka Imamura
- Department of Ophthalmology, Teikyo University School of Medicine, University Hospital Mizonokuchi, 5-1-1Takatsu-ku, FutagoKawasaki, Kanagawa, 213-8507, Japan
| | - Masaki Shibata
- Department of Ophthalmology, Teikyo University School of Medicine, University Hospital Mizonokuchi, 5-1-1Takatsu-ku, FutagoKawasaki, Kanagawa, 213-8507, Japan
| | - Yuko Komiya
- Department of Ophthalmology, Teikyo University School of Medicine, University Hospital Mizonokuchi, 5-1-1Takatsu-ku, FutagoKawasaki, Kanagawa, 213-8507, Japan
| | - Masahiro Ishida
- Department of Ophthalmology, Teikyo University School of Medicine, University Hospital Mizonokuchi, 5-1-1Takatsu-ku, FutagoKawasaki, Kanagawa, 213-8507, Japan.,Department of Ophthalmology, Toho University Ohashi Medical Center, Tokyo, Japan
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Ozsaygili C, Bayram N. Comparison of Anatomical and Functional Results of Surgeries Performed with Nitinol Flex Loop or Forceps in Primary Epiretinal Membrane. Semin Ophthalmol 2021; 36:507-516. [PMID: 33734940 DOI: 10.1080/08820538.2021.1890786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Purpose: To compare surgery's effect with nitinol flex loop (NFL) or forceps on retinal layers and functional outcomes in the primary epiretinal membrane (ERM).Methods: The operations were classified according to the use of the NFL or forceps. Automatic segmentation of the individual inner retinal layers was performed by spectral-domain optical coherence tomography software, and best-corrected visual acuity (BCVA) before surgery and at the last follow-up visit postoperatively were compared.Results: Forty-two eyes of 42 patients were included with a mean age of 66.9 ± 5.7 years. 45.2% of the surgeries were NFL assisted, 54.8% were forceps assisted. The mean follow-up duration was 9.8 ± 1.3 months. The mean BCVA was 0.79 ± 0.42 vs 0.77 ± 0.39 logMAR in the preoperative period and 0.42 ± 0.27 vs. 0.40 ± 0.21 logMAR at last follow-up in the NFL vs forceps group respectively (p= .403). The retinal nerve fiber layer (RNFL)(32.5% vs. 50.1%, p= .009), ganglion cell layer (18.1% vs. 41.4%, p= .021), inner plexiform layer (13.5% vs. 32.7%, p= .031) and inner nuclear layer (15.5% vs. 30.3%, p= .011) thickness decreased significantly more in the forceps group. The mean surgical time was not significantly different (45.2 ± 5.1 vs. 51.1 ± 6.1 minutes) in the NFL vs. forceps groups, respectively (p= .331).Conclusion: Following primary ERM surgery, the inner retinal layers become thinner; RNFL impacted the most, which was found higher in forceps assisted surgeries. This result shows that the NFL can be used safely in macular surgery.
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Affiliation(s)
- Cemal Ozsaygili
- Department of Ophthalmology, Kayserı City Training and Research Hospital, Kocasinan, Kayseri, TURKEY
| | - Nurettin Bayram
- Department of Ophthalmology, Kayserı City Training and Research Hospital, Kocasinan, Kayseri, TURKEY
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Ozturk M, Guven D, Kacar H, Karapapak M, Demir M. Functional and Morphological Results of Epiretinal Membrane Surgery in Idiopathic versus Diabetic Epiretinal Membranes. Semin Ophthalmol 2021; 36:366-372. [PMID: 33617394 DOI: 10.1080/08820538.2021.1890143] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE Idiopathic and diabetic epiretinal membranes (ERM) are different in terms of pathophysiology, etiology, and macular morphology, and thus might respond to surgical treatment differently. We aimed to compare the surgical results of two groups. METHODS Retrospective case series study of 71 eyes of 66 patients who underwent pars plana vitrectomy (PPV) due to idiopathic or diabetic ERM with at least 1-year follow-up. Examinations were performed before, and 1, 3, 6, and 12 months after surgery. The average macular thicknesses in nine sectors described by the Early Treatment Diabetic Retinopathy Study (ETDRS) were measured with spectral-domain optical coherence tomography (OCT), and BCVA was evaluated. ERM recurrence rates were investigated. RESULTS In both idiopathic and diabetic groups, retinal thickness (RT) changes occurred as long as 12 months after vitrectomy surgery for ERM. However, in the idiopathic group, significant changes were mainly seen in the first 6 months, while in the diabetic group changes slowed considerably between the third and sixth months, but again accelerated (becoming significant) during the last 6 months. CONCLUSIONS According to the findings of this study, as compared to those with idiopathic ERM, diabetic patients would likely see continuing benefits from ERM surgery 6 to 12 months post surgery. The BCVA changes of the two groups were similar. ILM peeling decreased ERM recurrence in the idiopathic group but not in the diabetic group.
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Affiliation(s)
- Mine Ozturk
- Haseki Training and Research Hospital, Clinic of Ophthalmology, University of Health Sciences, Istanbul, Turkey
| | - Dilek Guven
- Sisli Hamidiye Etfal Training and Research Hospital, Clinic of Ophthalmology, University of Health Sciences, Istanbul, Turkey
| | - Hakan Kacar
- Sisli Hamidiye Etfal Training and Research Hospital, Clinic of Ophthalmology, University of Health Sciences, Istanbul, Turkey
| | - Murat Karapapak
- Sisli Hamidiye Etfal Training and Research Hospital, Clinic of Ophthalmology, University of Health Sciences, Istanbul, Turkey
| | - Mehmet Demir
- Sisli Hamidiye Etfal Training and Research Hospital, Clinic of Ophthalmology, University of Health Sciences, Istanbul, Turkey
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Vitrectomy for Epiretinal Membranes: Ganglion Cell Features Correlate with Visual Function Outcomes. ACTA ACUST UNITED AC 2018; 2:1152-1162. [DOI: 10.1016/j.oret.2018.04.020] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2017] [Revised: 04/13/2018] [Accepted: 04/27/2018] [Indexed: 11/23/2022]
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12
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Comparison of Individual Retinal Layer Thicknesses after Epiretinal Membrane Surgery with or without Internal Limiting Membrane Peeling. J Ophthalmol 2018; 2018:1256781. [PMID: 30420914 PMCID: PMC6215557 DOI: 10.1155/2018/1256781] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Revised: 07/19/2018] [Accepted: 08/09/2018] [Indexed: 11/18/2022] Open
Abstract
Purpose To compare changes in the retinal layer thickness and visual outcomes in patients undergoing epiretinal membrane (ERM) surgery with or without internal limiting membrane (ILM) peeling. Methods Seventy-six eyes of 76 patients who underwent ERM surgery from January 2013 to March 2015 at the Department of Ophthalmology, Yonsei University College of Medicine, Seoul, South Korea, were analyzed. While ERM removal with ILM peeling was performed in ILM peeling (P) group (n=39), ILM peeling was not performed in non-ILM peeling (NP) group (n=37). Retinal layer segmentation was performed using optical coherence tomography images. Individual retinal layer thicknesses before and at 6 months after ERM surgery were compared. The postoperative best-corrected visual acuity (BCVA) was also compared. Results In the P group, the thicknesses of retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), and inner plexiform layer (IPL) were significantly reduced. In the NP group, significant decreases in the RNFL, GCL, IPL, inner nuclear layer, and outer plexiform layer were observed. The P group manifested a greater mean postoperative GCL (35.56 ± 1.53 µm vs 29.86 ± 2.16 µm; p=0.033) and less loss of GCL (−10.26 ± 1.91 µm vs −19.86 ± 2.74 µm; p=0.004) compared to the NP group. No statistically significant differences were observed when comparing the changes in BCVA. Conclusions This study demonstrates that ILM peeling for ERM surgery may result in better preservation of GCL compared to no ILM peeling.
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Gupta RK, Kaur I, Nag TC, Chhablani J. Diagnostic Electron Microscopy of Retina. Semin Ophthalmol 2018; 33:700-710. [PMID: 29388866 DOI: 10.1080/08820538.2017.1416415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The electron microscopy techniques were used in various fields as an analytical technique under in vitro conditions, which provides the sufficient resolution for better visualization and interpretation. This review gives a brief overview of the analytical application of transmission electron microscopy (TEM) and scanning electron microscopy (SEM) techniques and critical findings in different retinal pathologies. This review article aims to improvise understanding of retinal microstructures for clinicians which will help to improve the interpretation of the current advanced imaging techniques.
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Affiliation(s)
- Rishikesh Kumar Gupta
- a Kallam Anji Reddy Molecular Genetics Laboratory, Brien Holden Eye Research Centre , L V Prasad Eye Institute (KAR Campus) , Hyderabad , Telangana , India
| | - Inderjeet Kaur
- a Kallam Anji Reddy Molecular Genetics Laboratory, Brien Holden Eye Research Centre , L V Prasad Eye Institute (KAR Campus) , Hyderabad , Telangana , India
| | - Tapas C Nag
- c All India Institute of Medical Sciences , Department of Anatomy , New Delhi , India
| | - Jay Chhablani
- b Smt. Kanuri Santhamma Centre for Vitreo-Retinal Diseases , L V Prasad Eye Institute (KAR Campus) , Hyderabad , Telangana , India
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Kumagai K, Furukawa M, Suetsugu T, Ogino N. Increase in average foveal thickness after internal limiting membrane peeling. Clin Ophthalmol 2017; 11:605-611. [PMID: 28435209 PMCID: PMC5388209 DOI: 10.2147/opth.s134909] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To report the findings in three cases in which the average foveal thickness was increased after a thin epiretinal membrane (ERM) was removed by vitrectomy with internal limiting membrane (ILM) peeling. METHODS The foveal contour was normal preoperatively in all eyes. All cases underwent successful phacovitrectomy with ILM peeling for a thin ERM. The optical coherence tomography (OCT) images were examined before and after the surgery. The changes in the average foveal (1 mm) thickness and the foveal areas within 500 μm from the foveal center were measured. The postoperative changes in the inner and outer retinal areas determined from the cross-sectional OCT images were analyzed. RESULTS The average foveal thickness and the inner and outer foveal areas increased significantly after the surgery in each of the three cases. The percentage increase in the average foveal thickness relative to the baseline thickness was 26% in Case 1, 29% in Case 2, and 31% in Case 3. The percentage increase in the foveal inner retinal area was 71% in Case 1, 113% in Case 2, and 110% in Case 3, and the percentage increase in foveal outer retinal area was 8% in Case 1, 13% in Case 2, and 18% in Case 3. CONCLUSION The increase in the average foveal thickness and the inner and outer foveal areas suggests that a centripetal movement of the inner and outer retinal layers toward the foveal center probably occurred due to the ILM peeling.
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Affiliation(s)
| | - Mariko Furukawa
- Department of Ophthalmology, Kami-iida Daiichi General Hospital
| | | | - Nobuchika Ogino
- Department of Ophthalmology, Nishigaki Eye Clinic, Aichi, Japan
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