Secondary Epiretinal Membrane After Trabeculectomy

Vieira, Lorena Vasconcelos; Cabugueira, Ana; Borges, Bárbara; Carvalho, Vanessa Henriques; Noronha, Manuel; Pinto, Luís Abegão; Reina, Maria; Dutra-Medeiros, Marco

doi:10.1097/ijg.0000000000000326

Cited by 5 publications

(15 citation statements)

References 22 publications

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“…The frequency of the ERM in our study after Express glaucoma device implant was 33% and was lower than the reported one after trabeculectomy (56%) [16]. Interestingly, in most of our cases (83%), the ERM was a CMR and did not affect macular profile or symptomatology.…”

Section: Discussioncontrasting

confidence: 75%

“…The frequency of ERM after glaucoma surgery was higher than that reported after cataract surgery. It has been hypothesized that the longer operative time and the entity of the forces acting on vitreoretinal interface may contribute to explain this observation [16]. Giambruni et al did not demonstrate an association between the use of prostaglandin analogues and the development of ERM [35].…”

Section: Discussionmentioning

confidence: 98%

“…Descriptive statistic was used to summarize mean values and standard deviations of all numerical data. Sample size was calculated using the effect size from the results of a previous similar study [16] and indicated that 54 subjects were required to detect a 25.7% difference in the incidence of ERM, with a power of 80% and a significance level of 0.05. Post-hoc analysis indicated that this study had a power of 90% with an actual α of 0.02 to detect a 24% difference in the incidence of ERM between treated eyes and controls.…”

Section: Discussionmentioning

confidence: 99%

“…The ERM incidence after glaucoma surgery has been investigated by Vieria et al in 2016 [16]. In their retrospective study, they analysed the development and progression of ERM after trabeculectomy for primary open-angle glaucoma.…”

Section: Discussionmentioning

confidence: 99%

“…It has been hypothesized that glaucoma filtration surgery may predispose one to the development and progression of ERM [16]. To date, trabeculectomy is considered the gold standard for the surgical treatment of glaucoma.…”

Section: Introductionmentioning

confidence: 99%

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Secondary epiretinal membrane after Ex-Press glaucoma filtration device implant

Loiudice

Sartini

Figus

et al. 2020

Graefes Arch Clin Exp Ophthalmol

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Purpose To estimate the frequency of epiretinal membrane (ERM) in eyes with primary open-angle glaucoma (POAG) treated with Ex-Press shunt implant. Secondarily, we aimed to assess the role of concomitant cataract surgery and the impact of the ERM on central foveal thickness and macular volume. Methods In this prospective, consecutive, case-control study, we enrolled 54 patients affected by PAOG and scheduled for Ex-Press device implant with or without contemporary phacoemulsification. Contralateral eyes affected by POAG and receiving anti-glaucomatous eyedrops constituted the control group. Complete ophthalmologic evaluation and spectral-domain optical coherence tomography (OCT) were performed before and 1, 3 and 6 months after surgery. Results Twenty-six eyes received the Ex-Press implant alone, and 28 eyes underwent the combined procedure. Six months postoperatively, we observed 18 (33%) cases of ERM: 15 (28%) of cellophane macular reflex (CMR) and 3 (6%) of pre-macular fibrosis (PMF). In the control group, 9 (17%) eyes developed an ERM: 8 (15%) were CMR, and 1 (2%) was PMF. The frequency of ERM statistically differs between treated and contralateral eyes (P = 0.032, χ2 test). The ERM frequency did not statically differ between eyes subjected to simple or combined surgery (P = 0.846, χ2 test). Mean central foveal thickness and mean macular volume did not significantly differ between groups. Conclusion The Ex-Press glaucoma shunt may increase the risk of ERM onset regardless of the concomitant cataract surgery; however, most cases were cellophane macular reflex with limited functional and anatomical impact.

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Section: Discussioncontrasting

confidence: 75%

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Secondary epiretinal membrane after Ex-Press glaucoma filtration device implant

Loiudice

Sartini

Figus

et al. 2020

Graefes Arch Clin Exp Ophthalmol

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Epiretinal membrane development after Ex-Press glaucoma filtration device implant: 2-year results of a case control study

Sartini,

Menchini,

Palma

et al. 2024

Int Ophthalmol

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Background The most common retinal complications after glaucoma surgery are choroidal detachment, hypotony maculopathy, malignant glaucoma, vitreous hemorrhage, endophthalmitis and retinal detachment. However, if glaucoma surgery is a risk factor for the ERM development needs to be clarified. This study aims to assess the incidence of epiretinal membrane (ERM) in 2 years of follow-up in patients with primary open-angle glaucoma (POAG) treated with Ex-Press shunt implant. Methods A prospective, consecutive, single-center, case–control study. We enrolled patients affected by POAG and scheduled for Ex-Press device implant with or without concomitant cataract surgery. The control group was the contralateral eyes which continues anti-glaucomatous eyedrops. Complete ophthalmologic evaluation and spectral-domain optical coherence tomography were performed before surgery, at 6 months and 24 months of follow-up. Results Eighty-two eyes of 41 consecutive patients, 18 males and 23 females with a mean age of 70, 29 ± 8,45, were analyzed at 24 months. 39.1% of eyes developed ERM: 29.3% were cellophane macular reflex (CMR) and 9.8% were pre-macular fibrosis (PMF). In the control group, 19.5% of eyes developed ERM: 17.1% were CMR and 2.4% were PMF. No statistically significant difference was reported (p = 0.121) between treated and control group. ERM development did not affect significantly the central foveal thickness (260.13 ± 35.01 μm at baseline, 265.03 ± 34.90 μm at 6 months and 275.18 ± 33.31 μm at 24 months) and macular volume (7.75 ± 0.43 mm3 at baseline, 7.77 ± 0.48 mm3 at 6 months and 7.77 ± 0.46 mm3 at 24 months), remained comparable to reported average measures in healthy individuals during the follow-up. Concomitant cataract surgery did not increase the ERM incidence. Conclusion Ex-Press implant may increase the ERM incidence regardless concomitant cataract surgery, accelerating or inducing a posterior vitreous detachment, such as other ocular surgical procedure. Nevertheless, the vast majority of ERM are CMR, not affecting the macular profile.

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Müller Cell Cone–associated Foveal Detachment as a Risk Factor for Visual Acuity Loss After Glaucoma Filtering Surgery

Chihara

Matsuzaki

2021

Retina

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Purpose: To examine hypotony-associated foveal lesions (FovLs) using optical coherence tomography, and to assess the risk factors of visual deterioration after glaucoma filtering surgery.Methods: Parameters that may be associated with postsurgical deterioration of visual acuity were retrospectively studied in 44 eyes of 44 patients who experienced postsurgical intraocular hypotension #6 mmHg between 2015 and 2019.Results: Six eyes (14%) had FovLs, such as detachment of photoreceptors (5 eyes, 11%) and acquired vitelliform lesions (1 eye, 2%) at 3 months after trabeculectomy. Logistic regression analysis revealed that hypotony maculopathy (P = 0.0141 at 3 months) and FovLs (P = 0.0486 and 0.0296 at 3 and 12 months, respectively) were significant risk factors for Visual acuity loss after trabeculectomy. The FovLs were located just behind the Müller cell cone. Visual acuity at 3 and 12 months after surgery in patients with FovLs was significantly lower than in those without FovLs (P = 0.0013 and P = 0.006, respectively). Epiretinal membrane was more common in eyes with FovLs (5 of 6 eyes, 83%) than in eyes without FovLs (7 of 38 eyes, 18%; P = 0.0037).Conclusion: Müller cell cone-associated FovLs lead to long-lasting visual acuity loss after filtering surgery.

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Secondary Epiretinal Membrane After Trabeculectomy

Abstract: Trabeculectomy may predispose one to the appearance and progression of ERM. Further studies are needed to clarify this intriguing relation.

Cited by 5 publications

References 22 publications

Secondary epiretinal membrane after Ex-Press glaucoma filtration device implant

Secondary epiretinal membrane after Ex-Press glaucoma filtration device implant

Epiretinal membrane development after Ex-Press glaucoma filtration device implant: 2-year results of a case control study

Müller Cell Cone–associated Foveal Detachment as a Risk Factor for Visual Acuity Loss After Glaucoma Filtering Surgery

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