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Effect of Foveal Vitreous Cortex Removal to Prevent Epiretinal Membrane after Vitrectomy for Rhegmatogenous Retinal Detachment
- Source :
- Ophthalmology Retina. 5:420-428
- Publication Year :
- 2021
- Publisher :
- Elsevier BV, 2021.
-
Abstract
- Purpose To determine the effect of foveal vitreous cortex removal during pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RRD) on the prevention of postoperative epiretinal membrane (ERM) development without internal limiting membrane (ILM) peeling. Design Case-control study. Participants A total of 105 consecutive eyes of 105 patients who underwent primary PPV for RRD between September 2018 and August 2019 and were followed for at least 6 months. Methods The presence of foveal vitreous cortex during PPV was determined by examining the images obtained by a widefield viewing system in 52 eyes (WF group) operated in the first half of the study period and obtained by a high-magnification floating lens in 53 eyes (FL group) operated in the latter half of the study period. Triamcinolone acetonide was used to make the vitreous cortex more visible during PPV. The foveal vitreous cortex was removed if detected by forceps with a high-magnification floating lens without ILM peeling or use of dye staining. The presence of postoperative ERM was examined by using OCT. Main Outcome Measures The rate of detected and removed foveal vitreous cortex during PPV and the incidence of postoperative ERM of each group. Results The rate of detected and removed foveal vitreous cortex during PPV was significantly higher in the FL group than in the WF group (41.5% vs. 15.4%, P = 0.004). The incidence of postoperative ERM was significantly lower in the FL group than in the WF group (1.9% vs. 13.5%, P = 0.03). None of the eyes required additional surgery for the postoperative ERM during the follow-up period. The retinal reattachment rate was not significantly different (98.1% vs. 100%, P = 0.99), and the final retinal attachment rate was 100% in both groups. A dissociated optic nerve fiber layer appearance and a temporal macular thinning were not detected postoperatively in any of the eyes with removal of the foveal vitreous cortex during PPV. Conclusions The detection and removal of foveal vitreous cortex with the high-magnification floating lens during PPV for RRD significantly reduce the incidence of postoperative ERM without adverse findings.
- Subjects :
- Male
Pars plana
Fovea Centralis
medicine.medical_specialty
Triamcinolone acetonide
genetic structures
medicine.medical_treatment
Visual Acuity
Vitrectomy
Basement Membrane
03 medical and health sciences
chemistry.chemical_compound
Postoperative Complications
0302 clinical medicine
Japan
Foveal
Ophthalmology
medicine
Humans
030304 developmental biology
0303 health sciences
business.industry
Incidence
Retinal Detachment
Retinal detachment
Epiretinal Membrane
Retinal
Middle Aged
medicine.disease
eye diseases
medicine.anatomical_structure
chemistry
Vitreous membrane
Case-Control Studies
030221 ophthalmology & optometry
Female
sense organs
Epiretinal membrane
business
Tomography, Optical Coherence
medicine.drug
Subjects
Details
- ISSN :
- 24686530
- Volume :
- 5
- Database :
- OpenAIRE
- Journal :
- Ophthalmology Retina
- Accession number :
- edsair.doi.dedup.....59e424653263e78c213218be9b3438e5