Short Term Therapeutic Effect of Modified Epiretinal Membrane Surgery

Abstract

Objective: To compare the early therapeutic effects of modified epiretinal membrane surgery to traditional epiretinal membrane surgery for idiopathic epiretinal membrane (IERM). Methods: From February to August 2018, 30 eyes of 30 IERM patients who had been treated in Weifang Eye Hospital were selected consecutively and received surgical treatment independently performed by the same physician in Weifang Eye Hospital. The patients were divided into a traditional group and modified group using a simple random method. All 15 eyes in the traditional group were treated with vitrectomy and traditional epiretinal membrane peeling, while all 15 eyes in the modified group were treated with vitrectomy and epiretinal membrane blunt peeling. All patients were reviewed at 1 week,1 month, and 3 months after surgery. The best corrected visual acuity (BCVA) before and after the operation, the central retina thickness (CRT) (μm) measured by Spectralis OCT, the ganglion cell inner plexiform layer (GCIPL) (μm) measured by ganglion cell analysis (GCA) with Cirrus HD-OCT, the changes in retinal morphology in the macular area, and the amplitude densities and latencies of the P1 waves from the multifocal electroretinogram (mERG). Data were analyzed using t test. Results: Postoperative BCVA increased in both groups compared with preoperative measurements and the differences were statistically significant (traditional group: t=4.176, P=0.001; modified group: t=6.187, P<0.001). The BCVA in the modified group was significantly better than that in the traditional group (t=2.219, P=0.035). Postoperative CRT decreased in both groups compared with preoperative CRT and the differences were statistically significant (traditional group: t=5.666, P<0.001; modified group: t=13.905, P<0.001). The CRT in the modified group was significantly lower than that in the traditional group (t=2.144, P=0. 041). GCIPL thickness: There was no significant difference between the two groups before and after surgery, and no significant change before and after surgery (t=-3.350, P=0.066) in the traditional group, but there was an increase after surgery in the modified group (t=-14.148, P<0.001). The P-wave peak of the mERG 1 ring: No significant differences were found between the two groups before surgery (t=0.550, P=0.860). In the two group, there was an increase after surgery (traditional group: t=16.932, P<0.001; modified group: t=-29.701, P<0.001), and the results of the modified group was better than that of the traditional group (t=-20.882, P<0.001). Conclusions: Blunt peeling of the anterior epiretinal membrane is a practical, simple and safe treatment method. It can effectively restore the morphological structure of the macular area, improve the patient's vision and improve macular function. Key words: idiopathic epiretinal membrane; epiretinal membrane peeling; blunt peeling; inner retinal layer