1
|
Chen G, Tzekov R, Fang Y, Tong Y, Li W. Internal limiting membrane peeling in rhegmatogenous retinal detachment: A meta-analysis. PLoS One 2024; 19:e0297230. [PMID: 38489304 PMCID: PMC10942048 DOI: 10.1371/journal.pone.0297230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 12/29/2023] [Indexed: 03/17/2024] Open
Abstract
PURPOSE To determine whether pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peeling for rhegmatogenous retinal detachment (RRD) could get better functional and anatomical outcomes. METHODS A comprehensive literature search was performed to find relevant studies. A meta-analysis was conducted by comparing the weighted mean differences (WMD) in the mean change of best corrected visual acuity (BCVA) from baseline and calculating the odd ratios (OR) for rates of epiretinal membrane (ERM) formation and recurrence of retinal detachment (RD). RESULTS Fourteen studies were selected, including 2259 eyes (825 eyes in the ILM peeling group and 1434 eyes in the non-ILM peeling group). There was no significant difference in terms of mean change in BCVA from baseline and the rate of RD recurrence (WMD = 0.02, 95% CI, -0.20 to 0.24, P = 0.86, and OR = 0.55, 95% CI, 0.24 to 1.26, P = 0.16), but ILM peeling was associated with a significantly lower frequency of postoperative ERM formation (OR = 0.13, 95% CI, 0.06 to 0.26, P<0.00001). Similar results were obtained in a sub-analysis based on macula-off RRD. CONCLUSION ILM peeling results in similar BCVA, with same rate of RD recurrence, but lower rate of postoperative ERM development. ILM peeling could be considered in selected cases with risk factors that are likely to develop an ERM.
Collapse
Affiliation(s)
- Guohai Chen
- Department of Ophthalmology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou, Zhejiang, PR China
| | - Radouil Tzekov
- Department of Ophthalmology, University of South Florida, Tampa, Florida, United States of America
| | - Yan Fang
- Department of Ophthalmology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou, Zhejiang, PR China
| | - Yuhua Tong
- Department of Ophthalmology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou, Zhejiang, PR China
| | - Wensheng Li
- Shanghai Aier Eye Hospital, Shanghai, PR China
- Shanghai Aier Eye Institute, Shanghai, PR China
- Aier School of Ophthalmology, Central South University, Changsha, Hunan Province, PR China
| |
Collapse
|
2
|
Kanzaki Y, Matoba R, Ishihara K, Morita T, Muraoka Y, Kimura S, Koto T, Kawasaki R, Baba T, Okamoto F, Inoue M, Sakamoto T, Tsujikawa A, Morizane Y. Japan-epiretinal membrane (J-ERM) registry: A prospective cohort study protocol investigating the surgical outcome of epiretinal membrane. PLoS One 2024; 19:e0297347. [PMID: 38329968 PMCID: PMC10852224 DOI: 10.1371/journal.pone.0297347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 12/21/2023] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND Epiretinal membrane (ERM) causes visual impairment such as reduction in visual acuity and metamorphopsia due to retinal traction. With the improvement of optical coherence tomography (OCT) and microincision vitrectomy surgery (MIVS), the surgery of ERM has significantly advanced. However, there have been no large-scale studies on the following: (1) how to evaluate visual impairment in ERM, (2) the relationship between OCT findings and visual function, (3) when is the optimal timing of surgery, and (4) the relationship between the surgical instruments as well as techniques and prognosis. The purpose of this study was to obtain evidence regarding these ERM surgeries. METHODS AND DESIGN This is a prospective, multicenter cohort study of ERM surgery in Japan from March 1, 2023, to March 31, 2027 (UMIN000048472, R-3468-2). Patients who underwent ERM surgery during the study period and agreed to participate in this study will be included. The goal is to have a total of 5,000 eyes surgically treated for ERM. The following data will be collected: age, gender, medical history, subjective symptoms, visual function before and 6 and 12 months after surgery, clinical findings, OCT data, surgical technique, instruments used in surgery, and complications. DISCUSSION The results of this study will support the surgical decisions and procedures in ERM practices.
Collapse
Affiliation(s)
- Yuki Kanzaki
- Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama City, Okayama, Japan
| | - Ryo Matoba
- Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama City, Okayama, Japan
| | - Kenji Ishihara
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Sakyo-ku, Kyoto, Japan
| | - Tetsuro Morita
- Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama City, Okayama, Japan
| | - Yuki Muraoka
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Sakyo-ku, Kyoto, Japan
| | - Shuhei Kimura
- Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama City, Okayama, Japan
| | - Takashi Koto
- Kyorin Eye Center, Department of Ophthalmology, Kyorin University School of Medicine, Mitaka City, Tokyo, Japan
| | - Ryo Kawasaki
- Division of Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita City, Osaka, Japan
| | - Takayuki Baba
- Department of Ophthalmology and Visual Science, Chiba University Graduate School of Medicine, Chuo-ku, Chiba, Japan
| | - Fumiki Okamoto
- Department of Ophthalmology, Graduate School of Medicine, Nippon Medical School, Bunkyo-ku, Tokyo, Japan
| | - Makoto Inoue
- Kyorin Eye Center, Department of Ophthalmology, Kyorin University School of Medicine, Mitaka City, Tokyo, Japan
| | - Taiji Sakamoto
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima City, Kagoshima, Japan
| | - Akitaka Tsujikawa
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Sakyo-ku, Kyoto, Japan
| | - Yuki Morizane
- Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama City, Okayama, Japan
| |
Collapse
|
3
|
Obata S, Sawada O, Kakinoki M, Matsumoto R, Saishin Y, Ohji M. Effects of internal limiting membrane peeling on anatomical and functional outcomes in macula-off rhegmatogenous retinal detachment complicated by proliferative vitreoretinopathy: Japan-Retinal Detachment Registry. Jpn J Ophthalmol 2023:10.1007/s10384-023-01000-y. [PMID: 37289298 DOI: 10.1007/s10384-023-01000-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 04/26/2023] [Indexed: 06/09/2023]
Abstract
PURPOSE To investigate the effects of internal limiting membrane (ILM) peeling on retinal attachment after a single surgery, and on postoperative visual acuity (VA) at 6 months, in eyes with macula-off rhegmatogenous retinal detachment (RRD) complicated by proliferative vitreoretinopathy (PVR). STUDY DESIGN Nationwide, multicenter retrospective cohort study. METHODS The Japan-RD Registry database was used for analysis of patients who had undergone vitrectomy for macula-off RRD complicated by PVR. Multivariate analysis was performed to detect prognostic factors for retinal attachment after a single surgery and for VA at 6 months postoperatively. Retinal attachment after a single surgery or VA at 6 months postoperatively was the objective variable; ILM peeling, preoperative VA, PVR grade, age, and intraocular pressure were explanatory variables. RESULTS Eighty-nine eyes met the inclusion criteria; ILM peeling was performed in 25 eyes (28%). Preoperative VA was significantly associated with retinal attachment, but ILM peeling did not (odds ratios = 2.1 and 1.3, respectively; p = 0.009 and 0.67, respectively). Poor preoperative VA and younger patient age were significantly associated with poor postoperative VA, but ILM peeling was not (β-values = 0.37, -0.008, and 0.15, respectively; p < 0.001, p = 0.02, and p = 0.15, respectively. CONCLUSIONS Preoperative VA was a risk factor associated with retinal attachment. Preoperative VA and patient age were risk factors associated with postoperative poor VA. In eyes with macula-off RRD complicated by PVR, ILM peeling did not have a clear beneficial effect on anatomical and functional outcomes, suggesting that it may be unnecessary for eyes with this condition.
Collapse
Affiliation(s)
- Shumpei Obata
- Department of Ophthalmology, Shiga University of Medical Science, Seta Tsukinowacho, Otsu, Shiga, 520-2192, Japan.
| | - Osamu Sawada
- Department of Ophthalmology, Shiga University of Medical Science, Seta Tsukinowacho, Otsu, Shiga, 520-2192, Japan
- Japan-Retinal Detachment Registry Group, Osaka, Japan
| | - Masashi Kakinoki
- Department of Ophthalmology, Shiga University of Medical Science, Seta Tsukinowacho, Otsu, Shiga, 520-2192, Japan
- Japan-Retinal Detachment Registry Group, Osaka, Japan
| | - Riko Matsumoto
- Department of Ophthalmology, Shiga University of Medical Science, Seta Tsukinowacho, Otsu, Shiga, 520-2192, Japan
| | - Yoshitsugu Saishin
- Department of Ophthalmology, Shiga University of Medical Science, Seta Tsukinowacho, Otsu, Shiga, 520-2192, Japan
| | - Masahito Ohji
- Department of Ophthalmology, Shiga University of Medical Science, Seta Tsukinowacho, Otsu, Shiga, 520-2192, Japan
- Japan-Retinal Detachment Registry Group, Osaka, Japan
| |
Collapse
|
4
|
Lamas-Francis D, Bande-Rodríguez M, Blanco-Teijeiro MJ. Primary ILM peeling during retinal detachment repair: a systematic review and meta-analysis. Sci Rep 2023; 13:3586. [PMID: 36869054 PMCID: PMC9984489 DOI: 10.1038/s41598-023-30060-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 02/15/2023] [Indexed: 03/05/2023] Open
Abstract
Epiretinal membrane (ERM) formation is a known postoperative complication following retinal detachment (RD) repair surgery. Prophylactic peeling of the internal limiting membrane (ILM) during surgery has been shown to reduce the risk of developing postoperative ERM formation. Some baseline characteristics and degrees of surgical complexity may act as risk factors for ERM development. In this review we aimed to investigate the benefit of ILM peeling in patients without significant proliferative vitreoretinopathy (PVR) who underwent pars plana vitrectomy for RD repair. A literature search using PubMed and various keywords retrieved relevant papers from which data were extracted and analyzed. Finally, the results of 12 observational studies (3420 eyes) were summarized. ILM peeling significantly reduced the risk of postoperative ERM formation (RR = 0.12, 95% CI 0.05-0.28). The groups did not differ in final visual acuity (SMD 0.14 logMAR (95% CI - 0.03-0.31)). The risk of RD recurrence (RR = 0.51, 95% CI 0.28-0.94) and the need for secondary ERM surgery (RR = 0.05, 95% CI 0.02-0.17) were also higher in the non-ILM peeling groups. In summary, although prophylactic ILM peeling appears to reduce the rate of postoperative ERM, this benefit does not translate into consistent visual recovery across studies and potential complications must be considered.
Collapse
Affiliation(s)
- David Lamas-Francis
- Department of Ophthalmology, Hospital de Conxo, University Hospital of Santiago de Compostela, Ramón Baltar s/n, 15706, Santiago de Compostela, Spain.
| | - Manuel Bande-Rodríguez
- Department of Ophthalmology, Hospital de Conxo, University Hospital of Santiago de Compostela, Ramón Baltar s/n, 15706, Santiago de Compostela, Spain
| | - María José Blanco-Teijeiro
- Department of Ophthalmology, Hospital de Conxo, University Hospital of Santiago de Compostela, Ramón Baltar s/n, 15706, Santiago de Compostela, Spain
- Department of Surgery, University of Santiago de Compostela, Santiago de Compostela, Spain
| |
Collapse
|
5
|
Szigiato AA, Antaki F, Javidi S, Touma S, Duval R, Cordahi G, Olivier S, Rezende FA. Risk factors for epiretinal membrane formation and peeling following pars plana vitrectomy for primary rhegmatogenous retinal detachment, an OCT guided analysis. Int J Retina Vitreous 2022; 8:70. [PMID: 36180942 PMCID: PMC9524009 DOI: 10.1186/s40942-022-00418-9] [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: 08/09/2022] [Accepted: 09/08/2022] [Indexed: 11/23/2022] Open
Abstract
Background To evaluate the rate and risk factors of epiretinal membrane (ERM) formation and need for ERM peeling after pars plana vitrectomy (PPV) for uncomplicated primary rhegmatogenous retinal detachment (RRD). Methods Retrospective, single-center, cohort study of 119 consecutive patients (119 eyes) that underwent RRD repair using PPV. The primary outcomes were ERM formation, classified using an optical coherence tomography grading system, and the rate of ERM peeling. Visual acuity, postoperative complications, and risk factors for ERM formation and peeling were also identified. Results Postoperative ERM formation occurred in 69 eyes (58.0%); 56 (47.1%) were stage 1, 9 (7.6%) stage 2, 3 (2.5%) stage 3, and 1 (0.8%) stage 4. Only 6 (5.0%) eyes required secondary PPV for a visually significant ERM, with a mean time to reoperation of 488 ± 351 days. Risk factors for ERM formation included intraoperative cryotherapy, more than 1000 laser shots, 360° laser photocoagulation, and choroidal detachment (p < 0.01). Eyes with more than 3 tears had a trend towards increased ERM surgery (p = 0.10). Conclusions Visually significant ERM formation following PPV for primary RRD was uncommon in this cohort (5%). Half of the ERMs were detected after the first post-operative year, indicating that this complication may be underreported in studies with only 1-year follow-up.
Collapse
Affiliation(s)
| | - Fares Antaki
- Department of Ophthalmology, Hôpital Maisonneuve Rosemont, Montreal, Québec, Canada
| | - Simon Javidi
- Department of Ophthalmology, Hôpital Maisonneuve Rosemont, Montreal, Québec, Canada
| | - Samir Touma
- Department of Ophthalmology, Hôpital Maisonneuve Rosemont, Montreal, Québec, Canada
| | - Renaud Duval
- Department of Ophthalmology, Hôpital Maisonneuve Rosemont, Montreal, Québec, Canada
| | - Ghassan Cordahi
- Department of Ophthalmology, Hôpital Maisonneuve Rosemont, Montreal, Québec, Canada
| | - Sebastien Olivier
- Department of Ophthalmology, Hôpital Maisonneuve Rosemont, Montreal, Québec, Canada
| | - Flavio A Rezende
- Department of Ophthalmology, Hôpital Maisonneuve Rosemont, Montreal, Québec, Canada.
| |
Collapse
|
6
|
Zhang Y, Zhang L, Liu W. Effect of Intelligent Vital Sign Monitoring System on Postoperative Nursing Care of Severe Patients. CONTRAST MEDIA & MOLECULAR IMAGING 2021; 2021:1593005. [PMID: 34887707 PMCID: PMC8616669 DOI: 10.1155/2021/1593005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 10/18/2021] [Accepted: 10/27/2021] [Indexed: 11/18/2022]
Abstract
In order to study the observation of postoperative vital sign data of critically ill patients, this paper developed a set of vital sign data acquisition system based on intelligence and realized the design of vital sign data acquisition system APP based on Android Studio programming software, which was used to realize the information collection of vital sign data of patients. PDA is connected with a vital sign measuring equipment through Bluetooth. The patient's wristband is scanned with PDA to read the patient's information, and then the measured vital sign data are obtained automatically by measuring APP. The initial alarm value is set to be greater than 1%, and it needs more than 60 and less than or equal to 120 RR interval data to judge apnea. Information collection of intelligent vital sign detection can not only save the time of nursing staff but also improve the nursing quality.
Collapse
Affiliation(s)
- Yanhong Zhang
- ICU Unit 1, Harbin Medical University Cancer Hospital, Haerbin 150000, Heilongjiang, China
| | - Lifen Zhang
- Pharmacy Intravenous Admixture Service Center, Harbin Medical University Cancer Hospital, Haerbin 150000, Heilongjiang, China
| | - Wei Liu
- PET/CT-MR Center, Harbin Medical University Cancer Hospital, Haerbin 150000, Heilongjiang, China
| |
Collapse
|