A Novel Three-Step Technique for the Simple, Safe, and Efficient Complete Removal of Idiopathic Epiretinal Membrane.

IF 2.8 3区 医学 Q1 Pharmacology, Toxicology and Pharmaceutics
Therapeutics and Clinical Risk Management Pub Date : 2025-03-24 eCollection Date: 2025-01-01 DOI:10.2147/TCRM.S500766
Qingquan Wei, Chunyang Cai, Lan Yi, Meiling Li, Wufeng Zhang, Jili Chen, Qinghua Qiu
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Abstract

Purpose: This study aimed to assess a new three-phase method's efficacy and safety in treating idiopathic macular epiretinal membrane (ERM).

Methods: The novel technique involved a precise sequence: flap creation - wide margin- extensive peeling. Following the pars plana vitrectomy (PPV), to locate the epiretinal membrane, we stained the internal limiting membrane (ILM) with indocyanine green (ICG), using the stained ILM beneath as a guide to initiate the ERM flap. To minimize the force required for membrane peeling and traction on the underlying retina, we utilized a curved DSP scraper to form a wide-margin parallel arc along the inner aspect of the vascular arcade from the nasal to temporal side. Subsequently, the wide margin of the ERM was grasped tightly with ILM forceps, and traction was applied towards the central macular area to peel off the entire membrane. Finally, ICG staining was applied to ensure that the ERM was completely removed. The technique requires precise mastery of the three-step surgical skills and proficient use of specialized instruments.

Results: In a sample of 55 cases, the surgery achieved significant treatment outcomes. All surgeries were successfully performed with an average duration of 4.23±0.34 minutes for ERM peeling. At the 12-month postoperative follow-up, the mean logarithm of the minimum angle of resolution best-corrected visual acuity (BCVA) significantly improved from 4.74±0.30 to 4.27±0.34. The average central macular thickness (CMT) significantly decreased from 503.64±111.88μm to 353.38±72.64μm. There are no intraoperative or postoperative complications and there was no recurrence.

Conclusion: The novel technique is a fast, simple, effective and safe surgical technique for treating idiopathic ERM. It significantly improves visual outcomes and reduces the occurrence of complications and recurrence.

目的:本研究旨在评估一种新的三阶段法治疗特发性黄斑视网膜外膜(ERM)的有效性和安全性:这项新技术采用精确的顺序:制作皮瓣--宽边缘--广泛剥离。在进行玻璃体旁切除术(PPV)后,为了确定视网膜外膜的位置,我们用吲哚菁绿(ICG)对内缘膜(ILM)进行染色,以染色后的内缘膜下方为导向,启动视网膜外膜瓣。为了最大限度地减少剥膜所需的力量和对底层视网膜的牵引,我们使用了一个弯曲的 DSP 刮刀,沿着血管弧的内侧从鼻侧到颞侧形成一个宽边平行弧。然后,用 ILM 钳紧紧抓住 ERM 的宽边缘,并向黄斑中心区域施加牵引力,以剥离整个薄膜。最后进行 ICG 染色,以确保 ERM 被完全切除。这项技术要求精确掌握三步手术技巧,熟练使用专用器械:结果:在 55 例样本中,手术取得了显著的治疗效果。所有手术均成功实施,ERM剥离平均持续时间为(4.23±0.34)分钟。术后 12 个月随访时,最佳矫正视力(BCVA)最小分辨角的平均对数从(4.74±0.30)明显改善到(4.27±0.34)。黄斑中心平均厚度(CMT)从(503.64±111.88)μm 明显降低到(353.38±72.64)μm。术中和术后无并发症,无复发:新技术是治疗特发性 ERM 的一种快速、简单、有效和安全的手术技术。它能明显改善视觉效果,减少并发症和复发。
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来源期刊
Therapeutics and Clinical Risk Management
Therapeutics and Clinical Risk Management HEALTH CARE SCIENCES & SERVICES-
CiteScore
5.30
自引率
3.60%
发文量
139
审稿时长
16 weeks
期刊介绍: Therapeutics and Clinical Risk Management is an international, peer-reviewed journal of clinical therapeutics and risk management, focusing on concise rapid reporting of clinical studies in all therapeutic areas, outcomes, safety, and programs for the effective, safe, and sustained use of medicines, therapeutic and surgical interventions in all clinical areas. The journal welcomes submissions covering original research, clinical and epidemiological studies, reviews, guidelines, expert opinion and commentary. The journal will consider case reports but only if they make a valuable and original contribution to the literature. As of 18th March 2019, Therapeutics and Clinical Risk Management will no longer consider meta-analyses for publication. The journal does not accept study protocols, animal-based or cell line-based studies.
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