One‑year outcomes of 27G core‑pars plana vitrectomy of idiopathic epiretinal membrane

Abstract

The present study aimed to assess the feasibility and safety of 27G core-pars plana vitrectomy (PPV) for idiopathic epiretinal membrane (IERM). A retrospective analysis was performed on 38 eyes from 38 patients with IERM with a mean age of 62.73±5.61 years. 27G core-PPV was combined with IERM and internal limiting membrane (ILM) peeling. Pre-operative and post-operative best-corrected visual acuity (BCVA) and lens density were measured. Optical coherence tomography (OCT) and OCT angiography were performed to determine the patients' macular area. Ultrasound biomicroscopy and B-mode ultrasound were subsequently performed to observe any complications and the follow-up period ranged from 1 week to 12 months post-operatively. A total of 36 patients achieved visual improvement of ≥2 Snellen lines, of which 33 patients exhibited improvements within 1 week and the lens density remained unchanged. The mean central macular thickness significantly decreased at 12 months post-operatively (P≤0.05); however, it was not observed to be correlated with BCVA (r=0.41; P>0.05). The foveal avascular zone of the affected eye was significantly smaller than that of the healthy fellow eye (P≤0.05) and negatively correlated with post-operative BCVA (r=-0.72; P≤0.05). Superficial retinal capillary density and deep retinal capillary density decreased post-operatively (both P≤0.05) and no complications were observed. Taken together, the results of the present study indicate that application of 27G core-PPV with ILM peeling is minimally invasive for IERM and facilitates rapid post-operative BCVA recovery.

A classification of idiopathic epiretinal membrane based on foveal avascular zone area using optical coherence tomography angiography

“…Similar to our results, previous research reported that BCVA recovery was negatively related to the FAZ area [ 8 , 15 , 17 , 22 ] for postoperative correlation analyses. However, several studies reported controversial results that may be attributed to the varying sample sizes, instruments, and measurement depth [ 14 , 16 , 18 , 20 ].…”

Total and horizontal distances of the foveal stereotaxic displacement can be prognostic indicators for patients with idiopathic epiretinal membrane

“…The FAZ area and perimeter were significantly correlated with the baseline and postoperative BCVA. The correlation between FAZ area and baseline BCVA was also proven in previous studies ( 28 , 35 , 37 – 39 ) and BCVA recovery ( 28 , 37 , 40 , 41 ). Due to the differences in sample size, follow-up time, scanning depth range of different OCTA devices, and software vascular detection algorithm, many studies have controversial results on the correlation between FAZ-related indicators and visual acuity before ( 29 , 35 , 42 , 43 ) and after surgery ( 35 , 38 , 43 , 44 ).…”

Clinical Outcomes of 27-Gauge Pars Plana Vitrectomy for Diabetic Tractional Retinal Detachment Repair

“…Introduced in 2010, 27-gauge vitrectomy has gained popularity for a variety of vitreoretinal conditions, including epiretinal membranes, rhegmatogenous RDs (RRDs), macular holes, and vitreous hemorrhages. 9–14 It is reported to provide outcomes similar to those of 23-gauge and 25-gauge systems with respect to anatomic success, visual acuity (VA), and postoperative complications. 13,14 The benefits of 27-gauge PPV include faster wound closure, fewer cases of hypotony, and improved patient comfort, even in more complex cases.…”

“…13,14 The benefits of 27-gauge PPV include faster wound closure, fewer cases of hypotony, and improved patient comfort, even in more complex cases. [9][10][11][12][13][14] The smaller gauge instrumentation used in 27-gauge PPV enables more surgical precision and control because of the smaller distance between the opening of the cutter and the tip of the instrument, which allows the surgeon to use it as scissors during dissection at the retinal surface in diabetic TRD repair. 15 Despite the potential benefits of 27-gauge PPV for diabetic TRD, there has not been wide acceptance of this surgical modality and there is a paucity of outcomes reported in the literature.…”