Author: Maximilian Gabriel (Austria)
Co-authors: Daniel Djavid, Christoph Mayer-Xanthaki, Gerald Seidel, Domagoj Ivastinovic, Andreas Wedrich, Anton Haas
Purpose
To assess the feasibility of internal limiting membrane peeling in vitrectomies for idiopathic epiretinal membranes.
Setting/Venue
Explorative, prospective, single-center case series.
Methods
Patients with idiopathic epiretinal membranes were operated using 27-gauge vitrectomy. Exclusion criteria were myopia over 6 diopters, glaucoma, diabetes, idiopathic macular holes or pseudoholes, previous vitrectomy, patient age under 18 and other pathologic ocular conditions except cataract. Epiretinal membrane (ERM) peeling was performed with the aim to leave the internal limiting membrane (ILM) intact. Surgical success was therefore defined as ILM nonpeeling and evaluated by the surgeon intraoperatively. The presence of intraretinal hemorrhages in the peeled area and the inability to stain the ILM with a blue dye were defined as criteria for accidental ILM peeling. Metric parameters were descriptively summarized using mean and standard deviation (SD).
Results
25 eyes of 25 patients (14 men; 56%) were recruited and mean patient age at the time of surgery was 69.7 years (range 55 - 80, SD 6.7). ILM nonpeeling was achieved in 10 patients (40%). The patient group in which ILM nonpeeling was achieved showed no statistically significant differences in preoperative visual acuity (nonpeeling mean 0.52 Snellen, range 0.1 - 0.8, SD 0.2; peeling mean 0.45 Snellen, range 0.2 - 0.8, SD 0.16), axial eye length (nonpeeling mean 23.08 mm, range 21.02 - 24.14, SD 0.92; peeling mean 23.58 mm, range 21.98 - 25.12, SD 0.95) or preoperative spherical equivalent (nonpeeling mean 0.7 diopters, range -0.25 to +2.5, SD 0.2; peeling mean 0.18 mm, range -3.5 to +3.25, SD 1.76) compared to the ILM peeled group.
Conlusions
ILM nonpeeling was attainable in less than half of the cases in our series. Future trials should include more patients, determine preoperative anatomic or functional factors that could influence ERM/ILM adherence and compare anatomic and functional results of ILM peeled and nonpeeled eyes using multimodal imaging.
Financial Disclosure
None.
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