Effect of internal limiting membrane peeling on postoperative visual acuity in macula-off rhegmatogenous retinal detachment

Abstract

Purpose To investigate the effects of internal limiting membrane (ILM) peeling on visual acuity (VA) after rhegmatogenous retinal detachment (RRD) surgery. Methods This retrospective analysis examined the medical records of patients with RRD who underwent vitrectomy at 26 institutions. To detect prognostic factors of VA at 6 months postoperatively (post-VA), multivariate linear regression was performed with post-VA as the objective variable; ILM peeling, sex, age, preoperative VA (pre-VA), intraocular pressure, axial length, duration of RRD, and cataract surgery served as explanatory variables. Recurrence of RRD and epiretinal membrane formation within 6 months postoperatively were compared between groups of patients with and without ILM peeling, among patients with macula-on and macula-off RRD. Results The inclusion criteria were met by 523 eyes with a macula-on RRD and 364 eyes with a macula-off RRD. ILM peeling was performed in 85 eyes with a macula-on RRD and 57 eyes with a macula-off RRD. In eyes with a macula-on RRD, ILM peeling did not affect post-VA (p = 0.72). Vitrectomy without cataract surgery and poor pre-VA were significantly associated with poor post-VA (p = 0.01 and p < 0.001, respectively). In eyes with a macula-off RRD, ILM peeling, long duration of RRD, and poor pre-VA were significantly associated with poor post-VA (p = 0.037, p = 0.007, and p < 0.001, respectively). Recurrence of RRD and epiretinal membrane formation were similar between groups of patients with and without ILM peeling, among patients with macula-on and macula-off RRD. Retina sensitivity was not evaluated by microperimetry. Conclusion ILM peeling did not affect post-VA in eyes with a macula-on RRD, whereas post-VA was worse in eyes with ILM peeling than in eyes without peeling, among eyes with a macula-off RRD.

Risk factors for epiretinal membrane formation and peeling following pars plana vitrectomy for primary rhegmatogenous retinal detachment, an OCT guided analysis

“…Our findings are consistent with ERM formation rates in the recent literature [4,[6][7][8]. The formation of ERMs that are severe enough to warrant surgical intervention also vary in the literature, with rates as low as 1.6% up to 35% of eyes after PPV for primary RRD [16]. A recent meta-analysis of 586 eyes showed that an average of 16% of eyes required a second vitrectomy for ERM peeling [10].…”

“…The rate of re-operation was lower in our cohort, possibly due to advancements in surgical tools and techniques (including smaller gauge vitrectomy (25-gauge vs 20-gauge) and less use of cryotherapy). This decreased reoperation rate is despite a longer follow-up in our cohort (30 months vs 6-16 months) [3,[16][17][18][19]. This re-enforces that visually significant ERM formation is most likely to occur early in the post-operative course.…”

Effect of Intelligent Vital Sign Monitoring System on Postoperative Nursing Care of Severe Patients

“…Moore et al designed an Android application to detect the pulse signal through finger contact with the camera of a mobile phone and calculate the heart rate parameters [ 6 ]. Studies have shown that a kind of ECG monitoring on mobile phone “Heart Doctor” realizes the integration of basic functions of mobile phone and ECG monitoring through three metal electrodes on the surface and internal ECG acquisition module and realizes remote ECG monitoring by cooperating with mobile communication companies [ 7 ]. A mobile healthcare multiparameter physical sign monitoring system has been applied to community health monitoring and has been successfully used to monitor the physiological health of Jiaolong divers.…”

Incidencia y tiempo de aparición de membranas epirretinianas después de dos técnicas de retinopexia

“…En estudios comparativos para evaluar la incidencia de membranas epirretinianas después de vitrectomía con y sin retiro de la membrana limitante interna se reportan incidencias del 20% (Kumar et al 16 , n = 30), el 31% (Forlini et al 17 , n = 81) y el 46.4% (Arias et al 18 , n = 140) en los ojos que se intervinieron sin remoción quirúrgica de la membrana limitante, lo cual es consistente con los IC95% de nuestro estudio. La remoción quirúrgica de la membrana limitante interna durante la vitrectomía casi elimina la incidencia posoperatoria de membrana epirretiniana, pero puede llevar a una menor recuperación visual y a otras alteraciones funcionales clínicas o subclínicas 11,19 .…”