One‑year outcomes of 27G core‑pars plana vitrectomy of idiopathic epiretinal membrane

Liao,Xin; Keyal,Khusbu; Li,Hui; Wang,Fang

doi:10.3892/etm.2020.8995

One‑year outcomes of 27G core‑pars plana vitrectomy of idiopathic epiretinal membrane

Authors:
- Xin Liao
- Khusbu Keyal
- Hui Li
- Fang Wang
View Affiliations

Affiliations: Department of Ophthalmology, Shanghai 10th People's Hospital affiliated to Tongji University, Shanghai 200072, P.R. China
Published online on: July 13, 2020 https://doi.org/10.3892/etm.2020.8995
Pages: 2721-2729
Copyright: © Liao et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

The present study aimed to assess the feasibility and safety of 27G core‑pars plana vitrectomy (PPV) for idiopathic epiretinal membrane (IERM). A retrospective analysis was performed on 38 eyes from 38 patients with IERM with a mean age of 62.73±5.61 years. 27G core‑PPV was combined with IERM and internal limiting membrane (ILM) peeling. Pre‑operative and post‑operative best‑corrected visual acuity (BCVA) and lens density were measured. Optical coherence tomography (OCT) and OCT angiography were performed to determine the patients' macular area. Ultrasound biomicroscopy and B‑mode ultrasound were subsequently performed to observe any complications and the follow‑up period ranged from 1 week to 12 months post‑operatively. A total of 36 patients achieved visual improvement of ≥2 Snellen lines, of which 33 patients exhibited improvements within 1 week and the lens density remained unchanged. The mean central macular thickness significantly decreased at 12 months post‑operatively (P≤0.05); however, it was not observed to be correlated with BCVA (r=0.41; P>0.05). The foveal avascular zone of the affected eye was significantly smaller than that of the healthy fellow eye (P≤0.05) and negatively correlated with post‑operative BCVA (r=‑0.72; P≤0.05). Superficial retinal capillary density and deep retinal capillary density decreased post‑operatively (both P≤0.05) and no complications were observed. Taken together, the results of the present study indicate that application of 27G core‑PPV with ILM peeling is minimally invasive for IERM and facilitates rapid post‑operative BCVA recovery.

View Figures

View References

1	Seidel G, Weger M, Stadlmüller L, Pichler T and Haas A: Association of preoperative optical coherence tomography markers with residual inner limiting membrane in epiretinal membrane peeling. PLoS One. 8(e66217)2013.PubMed/NCBI View Article : Google Scholar
2	Reilly G, Melamud A, Lipscomb P and Toussaint B: Surgical outcomes in patients with macular pucker and good preoperative visual acuity after vitrectomy with membrane peeling. Retina. 35:1817–1821. 2015.PubMed/NCBI View Article : Google Scholar
3	Liu HY, Hsieh YT and Yang CM: Paravascular abnormalities in eyes with idiopathic epiretinal membrane. Graefes Arch Clin Exp Ophthalmol. 254:1723–1729. 2016.PubMed/NCBI View Article : Google Scholar
4	Hejsek L, Stepanov A, Dusova J, Marak J, Nekolova J, Jiraskova N and Codenotti M: Microincision 25G pars plana vitrectomy with peeling of the inner limiting membrane and air tamponade in idiopathic macular hole. Eur J Ophthalmol. 27:93–97. 2017.PubMed/NCBI View Article : Google Scholar
5	Do DV, Gichuhi S, Vedula SS and Hawkins BS: Surgery for post-vitrectomy cataract. Cochrane Database Syst Rev. 12(CD006366)2013.PubMed/NCBI View Article : Google Scholar
6	Mizutani Y, Sato Y and Shimda H: Outcome of nonvitrectomizing vitreous surgery for epimacular membranes. Nippon Ganka Kiyo. 52:302–306. 2001.
7	Oshima Y, Wakabayashi T, Sato T, Ohji M and Tano Y: A 27-gauge instrument system for transconjunctival sutureless microincision vitrectomy surgery. Ophthalmology. 117:93–102.e2. 2010.PubMed/NCBI View Article : Google Scholar
8	Chylack LT Jr, Wolfe JK, Singer DM, Leske MC, Bullimore MA, Bailey IL, Friend J, McCarthy D and Wu SY: The Lens Opacities Classification System III. The Longitudinal Study of Cataract Study Group. Arch Ophthalmol. 111:831–836. 1993.PubMed/NCBI View Article : Google Scholar
9	Chang WC, Lin C, Lee CH, Sung TL, Tung TH and Liu JH: Vitrectomy with or without internal limiting membrane peeling for idiopathic epiretinal membrane: A meta-analysis. PLoS One. 12(e0179105)2017.PubMed/NCBI View Article : Google Scholar
10	Varma R, Richter GM, Torres M, Foong AW, Choudhury F and Azen SP: Los Angeles Latino Eye Study Group. Four-year incidence and progression of lens opacities: The Los Angeles Latino Eye Study. Am J Ophthalmol. 149:728–34.e1, 2. 2010.PubMed/NCBI View Article : Google Scholar
11	Osawa S and Oshima Y: Innovations in 27-Gauge vitrectomy for sutureless microincision vitrectomy surgery. Rsetina. 4:42–45. 2014.PubMed/NCBI View Article : Google Scholar
12	Osawa S and Oshima Y: 27-Gauge vitrectomy. Dev Ophthalmol. 54:54–62. 2014.PubMed/NCBI View Article : Google Scholar
13	Kim YJ, Park SH and Choi KS: Fluctuation of infusion pressure during microincision vitrectomy using the constellation vision system. Retina. 35:2529–2536. 2015.PubMed/NCBI View Article : Google Scholar
14	Yoneda K, Morikawa K, Oshima Y, Kinoshita S and Sotozono C: Japan Microincision Vitrectomy Surgery Study Group. Japan microincision vitrectomy surgery study group. Surgical outcomes of 27-gauge vitrectomy for a consecutive series of 163 eyes with various vitreous diseases. Retina. 37:2130–2137. 2017.PubMed/NCBI View Article : Google Scholar
15	Sachdev R, Gupta A, Narula R and Deshmukh R: Limited vitrectomy in phacomorphic glaucoma. Indian J Ophthalmol. 65:1422–1424. 2017.PubMed/NCBI View Article : Google Scholar
16	Higaki S, Fukuda M, Matsumoto C and Shimomura Y: Results of penetrating keratoplasty triple procedure with 25-gauge core vitrectomy. Cornea. 31:730–733. 2012.PubMed/NCBI View Article : Google Scholar
17	Naser H, Koss MJ, Singh P and Koch F: Combined pharmacosurgery as treatment for diabetic macular edema: Core pars plana vitrectomy and intravitreal injection of bevacizumab and triamcinolone. Klin Monatsbl Augenheilkd. 228:910–914. 2011.PubMed/NCBI View Article : Google Scholar : (In German).
18	Rizzo S, Genovesi-Ebert F, Murri S, Belting C, Vento A, Cresti F and Manca ML: 25-gauge, sutureless vitrectomy and standard 20-gauge pars plana vitrectomy in idiopathic epiretinal membrane surgery: A comparative pilot study. Graefes Arch Clin Exp Ophthalmol. 244:472–479. 2006.PubMed/NCBI View Article : Google Scholar
19	Song SJ, Kuriyan AE and Smiddy WE: Results and prognostic factors for visual improvement after pars plana vitrectomy for idiopathic epiretinal membrane. Retina. 35:866–872. 2015.PubMed/NCBI View Article : Google Scholar
20	Gupta OP, Weichel ED, Regillo CD, Fineman MS, Kaiser RS, Ho AC, McNamara JA and Vander JE: Postoperative complications associated with 25-gauge pars plana vitrectomy. Ophthalmic Surg Lasers Imaging. 38:270–275. 2007.PubMed/NCBI View Article : Google Scholar
21	Nam Y, Chung H, Lee JY, Kim JG and Yoon YH: Comparison of 25- and 23-gauge sutureless microincision vitrectomy surgery in the treatment of various vitreoretinal diseases. Eye (Lond). 24:869–874. 2010.PubMed/NCBI View Article : Google Scholar
22	Saito Y, Lewis JM, Park I, Ikuno Y, Hayashi A, Ohji M and Tano Y: Nonvitrectomizing vitreous surgery: A strategy to prevent postoperative nuclear sclerosis. Ophthalmology. 106:1541–1545. 1999.PubMed/NCBI View Article : Google Scholar
23	Reibaldi M, Longo A, Avitabile T, Bonfiglio V, Toro MD, Russo A, Viti F, Nicolai M, Saitta A, Giovannini A, et al: Transconjunctival Nonvitrectomizing vitreous surgery versus 25-gauge vitrectomy in patients with epiretinal membrane: A Prospective Randomized Study. Retina. 35:873–879. 2015.PubMed/NCBI View Article : Google Scholar
24	Sakaguchi H, Oshima Y and Tano Y: 27-gauge transconjunctival nonvitrectomizing vitreous surgery for epiretinal membrane removal. Retina. 27:1302–1304. 2007.PubMed/NCBI View Article : Google Scholar
25	Sandali O, El Sanharawi M, Lecuen N, Barale PO, Bonnel S, Basli E, Borderie V, Laroche L and Monin C: 25-, 23-, and 20-gauge vitrectomy in epiretinal membrane surgery: A comparative study of 553 cases. Graefes Arch Clin Exp Ophthalmol. 249:1811–1819. 2011.PubMed/NCBI View Article : Google Scholar
26	Hikichi T, Matsumoto N, Ohtsuka H, Higuchi M, Matsushita T, Ariga H, Kosaka S and Matsushita R: Comparison of one-year outcomes between 23- and 20-gauge vitrectomy for preretinal membrane. Am J Ophthalmol. 147:639–643.e1. 2009.PubMed/NCBI View Article : Google Scholar
27	Stalmans P, Feron EJ, Parys-Van Ginderdeuren R, Van Lommel A, Melles GR and Veckeneer M: Double vital staining using trypan blue and infracyanine green in macular pucker surgery. Br J Ophthalmol. 87:713–716. 2003.PubMed/NCBI View Article : Google Scholar
28	Ahn SJ, Ahn J, Woo SJ and Park KH: Photoreceptor change and visual outcome after idiopathic epiretinal membrane removal with or without additional internal limiting membrane peeling. Retina. 34:172–181. 2014.PubMed/NCBI View Article : Google Scholar
29	Pournaras CJ, Emarah A and Petropoulos IK: Idiopathic macular epiretinal membrane surgery and ILM peeling: Anatomical and functional outcomes. Semin Ophthalmol. 26:42–46. 2011.PubMed/NCBI View Article : Google Scholar
30	Kim TW, Song SJ, Chung H and Yu HG: Internal Limiting Membrane Peeling In Surgical Treatment of Macular Epiretinal Membrane. J Korean Ophthalmol Soc. 6:989–994. 2005.PubMed/NCBI View Article : Google Scholar
31	Jung JJ, Hoang QV, Ridley-Lane ML, Sebrow DB, Dhrami-Gavazi E and Chang S: Long-term retrospective analysis of visual acuity and optical coherence Topographic changes after single versus double peeling during vitrectomy for macular epiretinal membranes. Retina. 36:2101–2109. 2016.PubMed/NCBI View Article : Google Scholar
32	Deák GG, Bolz M, Ritter M, Prager S, Benesch T and Schmidt-Erfurth U: Diabetic Retinopathy Research Group Vienna. A systematic correlation between morphology and functional alterations in diabetic macular edema. Invest Ophthalmol Vis Sci. 51:6710–6714. 2010.PubMed/NCBI View Article : Google Scholar
33	Laban KG, Scheerlinck LM and van Leeuwen R: Prognostic Factors Associated with Visual Outcome after Pars Plana Vitrectomy with Internal Limiting Membrane Peeling for Idiopathic Epiretinal Membrane. Ophthalmologica. 234:119–126. 2015.PubMed/NCBI View Article : Google Scholar
34	Muto T, Nishimura T, Yamaguchi T, Chikuda M and Machida S: Refractive changes after lens-sparing vitrectomy for macular hole and epiretinal membrane. Clin Ophthalmol. 11:1527–1532. 2017.PubMed/NCBI View Article : Google Scholar
35	Kitagawa Y, Shimada H, Shinojima A and Nakashizuka H: Foveal avascular zone area analysis using optical coherence tomography angiography before and after idiopathic epiretinal membrane surgery. Retina. 39:339–346. 2019.PubMed/NCBI View Article : Google Scholar
36	Kim YJ, Kim S, Lee JY, Kim JG and Yoon YH: Macular capillary plexuses after epiretinal membrane surgery: An optical coherence tomography angiography study. Br J Ophthalmol. 102:1086–1091. 2018.PubMed/NCBI View Article : Google Scholar
37	Yang S, Yao H, Li M, Li H and Wang F: Long Non-Coding RNA MALAT1 Mediates Transforming Growth Factor Beta1-Induced Epithelial-Mesenchymal Transition of Retinal Pigment Epithelial Cells. PLoS One. 11(e0152687)2016.PubMed/NCBI View Article : Google Scholar