Refractive change after vitrectomy for epiretinal membrane in pseudophakic eyes

PurposeCataract progression after lens-sparing vitrectomy might differ according to original posterior segment diseases. Our objective was to analyze the refractive values after lens-sparing vitrectomy for macular hole (MH) and epiretinal membrane (ERM).Materials and methodsWe reviewed the medical records of 25 MH patients (25 eyes) and 23 ERM patients (23 eyes) who underwent lens-sparing vitrectomy. Refractive changes in both groups were compared. All patients underwent 20-gauge three-port pars plana vitrectomy. Fluid–air exchange was performed during vitrectomy only in the MH group. The results were analyzed using the unpaired t-test, chi-square test, or Fisher exact probability test, and multivariate analysis.ResultsThere were no significant differences in the patient’s age (P=0.45). The myopia progression rate (D/month) was higher in the MH group after surgery than that in the ERM group (P=0.035). MH group had more females (P=0.043), longer surgical time (P<0.001), and higher frequencies of surgical adjuvants use (triamcinolone acetonide, P=0.019; brilliant blue G, P<0.001). The myopia progression rate in the MH group (R=0.568, P<0.001) correlated with female gender. However, no correlation was observed between longer surgical time and the use of surgical adjuvants.ConclusionThe rate of myopia progression was higher in the MH group. Fluid–air exchange and gender may affect the rate of myopia progression.

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“…Hamoudi et al reported that removal of vitreous gel itself played a role in the myopic change after vitrectomy without fluid gas exchange. 22 …”

Section: Discussionmentioning

confidence: 99%

Refractive changes after lens-sparing vitrectomy for macular hole and epiretinal membrane

Muto¹,

Nishimura²,

Yamaguchi³

et al. 2017

OPTH

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“…In this study, myopic shift caused by vitrectomy itself is not discussed. It is reported that pars plana vitrectomy alone also raises myopic shift by 0.2 D 11,12. Although this case may also be affected, the main reason for the refractive error is likely to be axial length estimation error.…”

Section: Discussionmentioning

confidence: 70%

Axial length estimation error caused by hidden double-peak on partial coherence interferometry in an eye with epiretinal membrane: a case report

Kitaguchi

Yano

Gomi

2014

OPTH

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Here we report a patient in whom there was a myopic shift after combined cataract surgery and pars plana vitrectomy against the epiretinal membrane, related to axial measurement estimation error caused by a hidden double-peak appearance on partial coherence interferometry measurement. A 52-year-old female presented with epiretinal membrane and underwent combined cataract surgery and pars plana vitrectomy. Axial length was measured with partial coherence interferometry. Although the signal curve in the summary display showed a single peak, a 1.6 diopter myopic shift occurred. Viewed retrospectively, six of 20 individual signal curves showed a double peak. Most of them showed a higher anterior peak, with only one having a higher posterior peak. The other 14 curves showed a single peak at a similar distance to an anterior peak. The anterior peak appeared to be derived from the epiretinal membrane. The possibility of a double peak should always be considered in patients with epiretinal membrane even if the summary display of the partial coherence interferometry measurement shows a single peak. Checking all signal curves would reduce the risk of missing a hidden double peak.

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“…No signi cant myopic shift was observed in our study when SE after lensectomy was compared with SE after PPV, even when comparing eyes with or without sutured sclerotomies, thus explaining why no refractive adjustment after vitrectomy was required. In a similar study of 28 pseudophakic eyes with a monofocal IOL, Hamoudi and Kofod in 2013 observed a clearly signi cant myopic shift after PPV, although the follow-up period was 8.5 months [25]. In another review article, Hamoudi and La Cour reported different shifts in SE, even though other conditions and techniques were included [26].…”

Section: Discussionmentioning

confidence: 99%

Visual outcomes after vitrectomy for epiretinal membrane in pseudophakic eyes with a diffractive trifocal intraocular lens.

Arrevola-Velasco¹,

Beltrán²,

Gimeno³

et al. 2021

Preprint

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Purpose: To evaluate the effect on visual outcomes of a diffractive trifocal intraocular lens (IOL) in pars plana vitrectomy (PPV) for removal of epiretinal membrane (ERM) in pseudophakic eyes. Methods: This is retrospective case-series study on 20 eyes with a single model of trifocal IOL that underwent PPV for removal of ERM between January 2015 and September 2018 in our clinics. Follow up was at least 1 year. Primary outcome measure was mean change in visual acuity. Other outcome measures were mean change in central macular thickness (CMT), recovery of the external retinal layers, and change in spherical equivalent (SE). Results: Mean corrected distance visual acuity (CDVA) was 0.03±0.03 logMAR after phacoemulsification; this worsened to 0.23±0.10 logMAR with ERM, improving to 0.10±0.04 log MAR 12 months after PPV (p=0.001). Mean uncorrected near visual acuity (UNVA) was Jaeger 2.62±0.51 after lensectomy. This worsened to Jaeger 5.46±1.67 with ERM and improved to the initial Jaeger 2.69±0.84 after PPV (p=0.005). CMT decreased significantly, from 380.15 ±60.50 µm with the ERM to 313.70 ±36.98 µm after PPV. Mean SE after lensectomy was -0.18 ±0.38 D, which minimally changed to – 0.18±0.47 D after PPV (p=0.99). The only complication recorded after PPV was a case of cystoid macular edema. No difficulties in visualization due to IOL design were reported during PPV. Conclusion: PPV for ERM in eyes with this trifocal IOL is safe and effective, and allows recovery of the loss of UNVA.

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Refractive change after vitrectomy for epiretinal membrane in pseudophakic eyes

Cited by 21 publications

References 31 publications

Refractive changes after lens-sparing vitrectomy for macular hole and epiretinal membrane

Refractive changes after lens-sparing vitrectomy for macular hole and epiretinal membrane

Axial length estimation error caused by hidden double-peak on partial coherence interferometry in an eye with epiretinal membrane: a case report

Visual outcomes after vitrectomy for epiretinal membrane in pseudophakic eyes with a diffractive trifocal intraocular lens.

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