Selective internal limiting membrane peeling for prevention of secondary epiretinal membrane after vitrectomy for rhegmatogenous retinal detachment

IF 2.1 3区医学 Q2 OPHTHALMOLOGY

Japanese Journal of Ophthalmology Pub Date : 2024-04-10 DOI:10.1007/s10384-024-01056-4

EunAh Kim, Youna Choi, Iksoo Byon, Ji Eun Lee, Sung Who Park

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引用次数: 0

Abstract

Purpose

We introduce selective internal limiting membrane (ILM) peeling, a guideline procedure to determine whether to remove the ILM during vitrectomy for rhegmatogenous retinal detachment (RRD).

Study design

Retrospective case series

Methods

Patients who underwent pars plana vitrectomy for RRD and were followed up for 12 months or longer were included. When vitreous cortex remnants (VCRs) were detected with triamcinolone acetonide, the ILM was removed; otherwise, the ILM was preserved (“selective ILM peeling”). The factors associated with the presence of VCRs and incidence of secondary epiretinal membrane (ERM) were analyzed.

Results

VCRs were detected in 87 of 133 eyes (65.4%) in which the ILM was removed. Younger age, better preoperative visual acuity, and vitreous hemorrhage were negatively correlated with the presence of VCRs. No ERM occurred in the eyes after ILM peeling. Among the eyes with ILM preservation, subclinical ERM was noticed in 4 eyes (8.7%), and 1 eye (2.1%) required additional surgery owing to ERM. ERM occurred more commonly in eyes with the ILM preserved (P = .004). However, no differences in the rate of additional surgeries were found between the 2 groups.

Conclusion

Selective ILM peeling offers an alternative option to reduce the burden of ILM peeling or additional surgery.

Abstract Image

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流变性视网膜脱离玻璃体切除术后选择性剥离内层限局膜以预防继发性视网膜外膜

研究设计回顾性病例系列研究方法纳入因视网膜脱离（RRD）接受玻璃体旁切除术且随访 12 个月或更长时间的患者。当使用曲安奈德丙酮检测到玻璃体皮质残余（VCR）时，切除ILM；否则，保留ILM（"选择性ILM剥离"）。分析了与 VCR 存在和继发性视网膜外膜 (ERM) 发生率相关的因素。结果在 133 只移除 ILM 的眼睛中，87 只（65.4%）发现了 VCR。年龄较小、术前视力较好和玻璃体出血与 VCR 的出现呈负相关。剥离ILM后的眼球没有发生ERM。在保留了ILM的眼球中，有4只眼球（8.7%）出现了亚临床ERM，有1只眼球（2.1%）因ERM而需要进行额外手术。ERM在保留ILM的眼球中发生率更高（P = .004）。结论选择性ILM剥离为减轻ILM剥离或额外手术的负担提供了另一种选择。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Japanese Journal of Ophthalmology 医学-眼科学

CiteScore

4.80

自引率

8.30%

发文量

审稿时长

6-12 weeks

期刊介绍： The Japanese Journal of Ophthalmology (JJO) was inaugurated in 1957 as a quarterly journal published in English by the Ophthalmology Department of the University of Tokyo, with the aim of disseminating the achievements of Japanese ophthalmologists worldwide. JJO remains the only Japanese ophthalmology journal published in English. In 1997, the Japanese Ophthalmological Society assumed the responsibility for publishing the Japanese Journal of Ophthalmology as its official English-language publication. Currently the journal is published bimonthly and accepts papers from authors worldwide. JJO has become an international interdisciplinary forum for the publication of basic science and clinical research papers.