Internal Limiting Membrane Peeling Versus Nonpeeling to Prevent Epiretinal Membrane Development in Primary Rhegmatogenous Retinal Detachment

Arias, Luís; Padron-Perez, Noel; Flores‐Moreno, Ignacio; Giralt, Lena; Cobos, Estefanía; Lorenzo, Daniel; Garcia‐Bru, Pere; Dias, Bernardo; Caminal, Josep M.

doi:10.1097/iae.0000000000002591

Cited by 16 publications

(18 citation statements)

References 21 publications

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“…Because this was a multicenter study, it was almost impossible to obtain follow-up data for a longer period than that used for data collection for the Registry. However, the follow-up period was also at least 6 months after the initial vitrectomy in other reports [ 3 , 27 ]. Those reports did not include follow-up for a full 12 months.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2021

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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.

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Section: Discussionmentioning

confidence: 99%

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

et al. 2021

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“…Previous studies have reported a range of risk factors associated with the formation of ERM after RRD repair, including age (4) , equatorial breaks (8) , cryopexy (9) , repeated operations (10) , proliferative vitreoretinopathy (11) , macular involvement (3) , low preoperative visual acuity (12) , and multiple and/or large retinal breaks (4) . Our study recorded that horseshoe breaks and giant retinal tears were significantly associated with the ERM development.…”

Section: Discussionmentioning

confidence: 99%

Presumed acute posterior multifocal placoid pigmentary epitheliopathy associated with Bartonella infection

Sousa¹,

Zett²,

Arraes³

et al. 2023

ABO

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To investigate the incidence, risk factors, and visual outcomes of epiretinal membrane development following rhegmatogenous retinal detachment repair. Methods: This was a retrospective study of 309 eyes that underwent initial surgery for primary uncomplicated rhegmatogenous retinal detachment. Examinations were conducted preoperatively and then postoperatively at 1, 3, 6, and 12 months. The study patients were categorized into two groups depending on the presence or absence of the epiretinal membrane. Results: The incidence of postoperative epiretinal membrane was 28.5%; 42.7% of these patients had severe epiretinal membrane development and therefore underwent the epiretinal membrane removal. Logistic regression analyses revealed that giant retinal tears (OR: 2.66; 95% CI: 1.045-6.792, p=0.040) and horseshoe tears (OR: 0.534; 95% CI: 0.295-0.967, p=0.039) were the significant predictors of postoperative epiretinal membrane. Triamcinolone acetonide staining was significantly associated with the prevention of epiretinal membrane (p=0.022). A total of 34 patients showed a better or an equal final best-corrected visual acuity; of which 4 eyes were evaluated at the final follow-up visit and exhibited a reduced best-corrected visual acuity. Conclusion: Our analysis demonstrated that horseshoe tears and giant retinal tears represent the risk factors for the postoperative epiretinal membrane. Triamcinolone acetonide staining had a significant preventive effect on the postoperative epiretinal membrane. Furthermore, a second round of pars plana vitrectomy, including membrane removal, led to a significant improvement in the final best-corrected visual acuity as per the last follow-up examination, albeit the recovery was limited.

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“…ILM peeling leads to mechanical trauma in the retinal microstructures, which can result in the dimple sign, pitting, temporal macular thinning, and concentric macular dark spots ( Figure 3(a) ) [ 6 ]. However, the effect of this anatomical damage on visual function remains controversial [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

“…For the statistical analysis, VA in decimal fraction was transformed to the logarithm of the minimum angle of resolution (logMAR). Low VA states were recorded as follows: counting fingers (logMAR = 1.7), hand motion (logMAR = 1.8), light perception (logMAR = 1.9), and no light perception (logMAR = 2.0) [ 6 ].…”

Section: Methodsmentioning

confidence: 99%

“…Thus, ILM peeling may help to reduce ERM formation. In the treatment of proliferative vitreoretinopathy (PVR) [ 5 ] and primary rhegmatogenous retinal detachment (RRD) [ 6 ], ILM peeling may successfully prevent the development of a postoperative ERM. However, the effect of ILM peeling on preventing an ERM after surgical treatment of OGI remains unclear.…”

Section: Introductionmentioning

confidence: 99%

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Internal Limiting Membrane Peeling versus Nonpeeling to Prevent Epiretinal Membrane Formation following Vitrectomy for Posterior Segment Open-Globe Injury

Wei

Zhong

et al. 2021

Journal of Ophthalmology

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Purpose. Approximately 30% of patients with an open-globe injury (OGI) develop a secondary epiretinal membrane (ERM). This study was performed to assess whether internal limiting membrane (ILM) peeling in the treatment of posterior segment OGI prevents ERM formation. Methods. The medical records of 33 patients who underwent vitrectomy for posterior segment OGI from 2016 to 2019 were retrospectively analyzed. Of these patients, 17 underwent ILM peeling during the vitrectomy and 16 did not. The patients’ demographic and surgical data were collected. The associations of ILM peeling with the preoperative findings of posterior segment OGI and development of a postoperative ERM were analyzed. Student’s t-test was used to evaluate differences in continuous variables, and the chi-squared test or Fisher’s exact test was used for categorical variables. Time-to-event curves were calculated from postestimation Cox proportional hazards models. Results. An ERM developed in three eyes (17.6%) in the ILM peeling group and in eight eyes (50.0%) in the nonpeeling group ( p < 0.05 ). There was no statistically significant difference between the groups in visual acuity at baseline (1.68 vs. 1.58 logMAR, p = 0.68 ) or at final follow-up (0.72 vs. 0.78 logMAR, p = 0.66 ). Median visual acuity significantly improved in both groups ( p < 0.001 ). In the multivariable models, ILM peeling (odds ratio, 0.19; 95% confidence interval, 0.04–0.91; p = 0.04 ) and worse preoperative vision (odds ratio, 0.29; 95% confidence interval, 0.10–0.80; p = 0.02 ) were associated with lower likelihood of ERM formation. Conclusion. Preventative treatment with ILM peeling contributed to decreased development of an ERM in patients with OGI involving areas near the fovea.

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Internal Limiting Membrane Peeling Versus Nonpeeling to Prevent Epiretinal Membrane Development in Primary Rhegmatogenous Retinal Detachment

Cited by 16 publications

References 21 publications

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

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

Presumed acute posterior multifocal placoid pigmentary epitheliopathy associated with Bartonella infection

Internal Limiting Membrane Peeling versus Nonpeeling to Prevent Epiretinal Membrane Formation following Vitrectomy for Posterior Segment Open-Globe Injury

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