Effect of Subfoveal and Extrafoveal Hyporeflective Zones due to Iatrogenic Traction during Membrane Peeling for Epiretinal Membranes on Postoperative Outcomes

2019 ◽  
Vol 243 (4) ◽  
pp. 297-302 ◽  
Author(s):  
Christoph Leisser ◽  
Christoph Hackl ◽  
Nino Hirnschall ◽  
Oliver Findl
Keyword(s):  
Postoperative Outcomes ◽  
Epiretinal Membranes ◽  
Membrane Peeling

Vitrectomy With Membrane Peeling for Vasocentric Idiopathic Epiretinal Membranes

Retina ◽  
2008 ◽  
Vol 28 (7) ◽  
pp. 981-986 ◽  
Author(s):  
Maged S. Habib ◽  
David H. Steel ◽  
Roland Ling ◽  
Charles James ◽  
Timothy J. Fetherston ◽  
...  
Keyword(s):  
Epiretinal Membranes ◽  
Membrane Peeling

Effect of Air Tamponade among Patients with Epiretinal Membranes and Intraretinal Cystoid Changes Undergoing Vitrectomy with Membrane Peeling – A Prospective Randomized Trial

2021 ◽  
Author(s):  
Christoph Leisser ◽  
Manuel Ruiss ◽  
Caroline Pilwachs ◽  
Julius Hienert ◽  
Kristina Stjepanek ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Statistical Significance ◽  
Randomized Study ◽  
Epiretinal Membranes ◽  
Membrane Peeling ◽  
Corrected Distance Visual Acuity ◽  
Study Population ◽  
Pars Plana ◽  
Air Tamponade

Abstract Background The effect of air tamponade among patients undergoing vitrectomy with membrane peeling for removal of epiretinal membranes (ERM) is controversially discussed. The aim of the present study was to analyze differences in outcomes between air tamponade and balanced salt solution (BSS) in a study population with preoperative intraretinal cystoid changes. Patients and Methods This randomized study included patients scheduled for pars plana vitrectomy with membrane peeling owing to ERM and intraretinal cystoid changes. Air tamponade or BSS at the end of surgery was applied according to preoperative randomization. Optical coherence tomography and best-corrected distance visual acuity (DCVA) measurements were performed before surgery, 5 days after surgery, and 3 months after surgery. Results From 96 patients included, 85 eyes had full follow-up and could be included for analysis. Median improvement of DCVA was + 16 EDTRS letters (IQR: 8 to 22) among patients with BSS, while it was + 13 EDTRS letters (IQR: 8 to 17) among patients with air tamponade. There was a trend for better improvement of DCVA when BSS was left at the end of surgery, compared to air tamponade, but not reaching statistical significance. Conclusions There were no statistically significant differences concerning resorption of preoperative intraretinal cystoid changes, improvement of visual acuity, and final DVCA between air tamponade and BSS.

scholarly journals Vitrectomy for the removal of idiopathic epiretinal membrane with or without internal limiting membrane peeling: a meta-analysis

2020 ◽  
Vol 12 ◽  
pp. 251584142092713 ◽  
Author(s):  
Eleni Christodoulou ◽  
Georgios Batsos ◽  
Petros Galanis ◽  
Christos Kalogeropoulos ◽  
Andreas Katsanos ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Epiretinal Membrane ◽  
Meta Analysis ◽  
Internal Limiting Membrane ◽  
Foveal Thickness ◽  
Epiretinal Membranes ◽  
Internal Limiting Membrane Peeling ◽  
Membrane Peeling ◽  
Central Foveal Thickness ◽  
Corrected Visual Acuity

Purpose: The aim of this study is to analyze the effect of internal limiting membrane peeling in removal of idiopathic epiretinal membranes through meta-analysis. Methods: We searched PubMed for studies published until 30 April 2018. Inclusion criteria included cases of idiopathic epiretinal membranes, treated with vitrectomy with or without internal limiting membrane peeling. Exclusion criteria consisted of coexisting retinal pathologies and use of indocyanine green to stain the internal limiting membrane. Sixteen studies were included in our meta-analysis. We compared the results of surgical removal of epiretinal membrane, with or without internal limiting membrane peeling, in terms of best-corrected visual acuity and anatomical restoration of the macula (central foveal thickness). Studies or subgroups of patients who had indocyanine green used as an internal limiting membrane stain were excluded from the study, due to evidence of its toxicity to the retina. Results: Regarding best-corrected visual acuity levels, the overall mean difference was –0.29 (95% confidence interval: –0.319 to –0.261), while for patients with internal limiting membrane peeling was –0.289 (95% confidence interval: –0.334 to –0.244) and for patients without internal limiting membrane peeling was –0.282 (95% confidence interval: –0.34 to –0.225). Regarding central foveal thickness levels, the overall mean difference was –117.22 (95% confidence interval: –136.70 to –97.74), while for patients with internal limiting membrane peeling was –121.08 (95% confidence interval: –151.12 to –91.03) and for patients without internal limiting membrane peeling was –105.34 (95% confidence interval: –119.47 to –96.21). Conclusion: Vitrectomy for the removal of epiretinal membrane combined with internal limiting membrane peeling is an effective method for the treatment of patients with idiopathic epiretinal membrane.

Effect of Periocular Triamcinolone Acetonide on Prevention of Postsurgical Intraretinal Cystoid Changes after Vitrectomy with Membrane Peeling

2021 ◽  
Author(s):  
Christoph Leisser ◽  
Wilhelm Burgmüller ◽  
Oliver Findl
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Macular Edema ◽  
Triamcinolone Acetonide ◽  
Epiretinal Membranes ◽  
Membrane Peeling ◽  
Corrected Visual Acuity ◽  
Historical Group ◽  
Pars Plana

Abstract Background Newly developed intraretinal cystoid changes after vitrectomy with membrane peeling for removal of epiretinal membranes have the potential to lead to worse postsurgical results compared to patients without. The aim of the present study was to evaluate the feasibility of additional periocular application of triamcinolone acetonide as a routine adjunct at the end of vitrectomy with membrane peeling, and to compare the presence of postsurgical intraretinal cystoid changes in the first 3 months after surgery among patients with idiopathic epiretinal membranes to a historical group of patients that did not receive triamcinolone acetonide. Patients and Methods The medical records of 41 eyes of 41 patients that underwent 23 G or 25 G pars plana vitrectomy with membrane peeling for removal of epiretinal membranes and additional periocular triamcinolone acetonide application at the end of surgery were retrospectively reviewed. Optical coherence tomography findings during routine follow-ups at 3 – 5 days, 1 month, and 3 months and visual acuity at 3 months after surgery were evaluated and compared to preoperative findings. Furthermore, postsurgical intraocular pressure was assessed. Results Periocular triamcinolone acetonide at the end of surgery was well tolerated among all patients. In total, 10% of patients had an increased intraocular pressure at least at one follow-up. Best-corrected visual acuity improved in 91% of patients with idiopathic epiretinal membranes with a mean improvement of + 3 ± 2 lines (Snellen) and was comparable to a historic group of patients (p = 0.307). Early transient macular edema could not be detected in any of the patients, while there were cases with this pathology in the historic group of patients, but neither occurrence of newly developed intraretinal cystoid changes nor macular thickness at 3 months after surgery were significantly different between patients with and without triamcinolone acetonide (p = 0.385 and p = 0.879). Conclusions Periocularly applied triamcinolone acetonide at the end of vitrectomy with membrane peeling was well tolerated and showed prevention of early transient macular edema but did not prevent the development of new postoperative intraretinal cystoid changes.

Effect of phacoemulsification on outcomes after vitrectomy with membrane peeling regarding new intraretinal cystoid changes and transient macular edema

2020 ◽  
Author(s):  
Christoph Leisser ◽  
Nino Hirnschall ◽  
Oliver Findl
Keyword(s):  
Optical Coherence Tomography ◽  
Macular Edema ◽  
Retrospective Analysis ◽  
Prospective Studies ◽  
Pars Plana Vitrectomy ◽  
Statistical Significance ◽  
Optical Coherence ◽  
Epiretinal Membranes ◽  
Membrane Peeling ◽  
Pars Plana

Purpose: Aim of the present study was to analyze the effect of phacoemulsification on outcomes among patients undergoing vitrectomy with membrane peeling for idiopathic epiretinal membranes, with respect to new postoperative intraretinal cystoid changes and early transient macular edema. Procedures: This retrospective analysis included patients from six prospective studies, examining outcomes of 23G pars plana vitrectomy with membrane peeling due to idiopathic epiretinal membranes. Phacovitrectomy with membrane peeling was performed only in case of coexisting vision affecting cataract. Optical coherence tomography was performed prior to surgery, in the first week and 3 months after surgery. Results: In total, 183 patients were included. Occurrence of new postoperative intraretinal cystoid changes and early transient macular edema showed a trend to be higher among patients undergoing phacovitrectomy with membrane peeling, compared to vitrectomy with membrane peeling alone, but did not reach statistical significance (p=0.5 and p=0.186). Final BCVA 3 months after surgery was significantly lower among patients with new postoperative intraretinal cystoid changes, compared to patients without (with a median difference of 1 line between groups, p=0.016). Conclusions: New postoperative intraretinal cystoid changes and early transient macular edema are more frequent among patients undergoing phacovitrectomy with membrane peeling, compared to patients with vitrectomy with membrane peeling alone.

Sign in / Sign up

Export Citation Format

Share Document