Author: Micha_ Post (Poland)
Co-authors: Maria Vittoria Cicinelli, Emma Clara Zanzottera, Francesco Bandello, Alessandro Marchese, Jacek Paweł Szaflik, Michele Coppola
Purpose
To assess the factors associated with external limiting membrane (ELM)/ellipsoid zone (EZ) damage after pars plana vitrectomy (PPV) for idiopathic epiretinal membrane (ERM) and evaluate their impact on the functional and anatomic recovery rate
Setting/Venue
1 Ophthalmology Unit, Azienda Ospedaliera di Monza, Monza, Italy 2 Department of Ophthalmology, SPKSO Ophthalmic Hospital, Medical University of Warsaw 3 School of Medicine, Vita-Salute San Raffaele University, Milan, Italy 4 Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy * Dr Post and Dr Cicinelli contributed equally as co-first authors.
Methods
Single-center, retrospective cohort study. Consecutive patients who underwent PPV with ERM ± inner limiting membrane (ILM) peeling were analyzed. Best-corrected visual acuity (BCVA) and central macular thickness (CMT) were collected at baseline and for one year. Demographic data, surgical details, and baseline features were included as covariates in a multivariable logistic regression model having ELM/EZ loss as binary outcome. Odds ratio (OR) and 95% confidence intervals (CI) were calculated. Factors influencing BCVA and CMT recovery rates were explored with linear regression models.
Results
Overall, 179 eyes of 171 patients were included. Thirty-four eyes (19%) had ELM/EZ loss after surgery; in 9 eyes (5%) ELM/EZ loss persisted at 12 months. Phacoemulsification at the time of PPV (OR=6.97, 95% CI 1.22-33.08, p=0.007) and presence of ELM/EZ damage before PPV (OR=6.91, 95% CI 1.74-31.10, p=0.007) were risk factors for postoperative ELM/EZ disruption. Thicker outer nuclear layer (p=0.002), thicker ectopic inner foveal layer (p<0.001), and high endoillumination power (p=0.03) were associated with slower visual recovery. ILM peeling (p=0.04) was associated with slower anatomic recovery.
Conlusions
Additional procedures during PPV and ERM peeling are associated with ELM/EZ defects after surgery and slower rate of anatomic improvement, but do not preclude good visual outcomes.
Financial Disclosure
none
Comments
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