Intraoperative Foveal Traction in Patients with Epiretinal Membrane

Hye Min Jeon; Sue Hey Chae; Chan Woo Bang; Min Soo Lee; Hee Seong Yoon

doi:10.3341/jkos.2018.59.8.738

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Jeon, Chae, Bang, Lee, and Yoon: Intraoperative Foveal Traction in Patients with Epiretinal Membrane

Original Article

Journal of the Korean Ophthalmological Society 2018; 59(8): 738-744.

Published online: 14 August 2018

DOI: https://doi.org/10.3341/jkos.2018.59.8.738

Intraoperative Foveal Traction in Patients with Epiretinal Membrane

Hye Min Jeon, MD, Sue Hey Chae, MD, Chan Woo Bang, MD, Min Soo Lee, MD, Hee Seong Yoon, MD, PhD

Sungmo Eye Hospital, Busan, Korea.

Address reprint requests to Hee Seong Yoon, MD, PhD. Sungmo Eye Hospital, #409 Haeun-daero, Haeundae-gu, Busan 48064, Korea. Tel: 82-51-743-0775, Fax: 82-51-743-0776, heesyoon@dreamwiz.com

Received 26 April 2018 Revised 29 May 2018 Accepted 30 July 2018

The Korean Ophthalmological Society

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To determine influences of intraoperative foveal traction during membrane peeling in idiopathic epiretinal membrane (ERM) surgery.

Methods

This retrospective observational study included 46 eyes of 46 patients with idiopathic ERM who underwent pars plana vitrectomy with ERM and internal limiting membrane peeling from February 2015 to September 2015. The presence of intraoperative foveal traction during membrane peeling was reviewed using video records. The main outcome measures were best-corrected visual acuity (BCVA), central foveal thickness (CFT), foveal contour, and photoreceptor inner segment/outer segment junction disruption using optical coherence tomography at baseline and at 1, 3, 6, and 12 months after surgery.

Results

Group 1 (ERM with intraoperative foveal traction) included 22 eyes, and group 2 (ERM without intraoperative foveal traction) included 24 eyes. Preoperatively, convex pattern ERM was observed more often in group 1. Group 1 had a significantly thicker CFT and a lower BCVA compared to group 2 at baseline and during the first 6 months, but the final postoperative BCVA and CFT were not significantly different between the groups at 12 months. Among 22 eyes, 12 eyes (54.5%) were restored to flat or concave ERM patterns at an average of 5.4 months after surgery in group 1, and 18 out of 24 eyes (75%) recovered at 2.4 months (p < 0.01) in group 2.

Conclusions

Preoperative thick CFT and convex pattern ERM indicated a high possibility of intraoperative foveal traction in idiopathic ERM surgery. There were no differences in long-term BCVA and restoration of foveal configuration according to foveal traction during membrane peeling.

Keywords: Idiopathic epiretinal membrane, Intraoperative foveal traction, Membrane peeling, Vitrectomy

Figures and Tables

Figure 1

Schema of the retinal membrane peeling. A drawing shows foveal traction during membrane peeling.

Figure 2

Mean longitudinal changes in best corrected visual acuity (BCVA). Traction group had a lower BCVA compared to non-traction group at baseline and during the first 6 months, but final postoperative BCVA were not significantly different between the groups at 12 months. mo = month(s). ^*p < 0.05, student's T-test.

Figure 3

Mean longitudinal changes in central foveal thickness (CFT). Traction group had a thicker CFT compared to non-traction group at baseline and during the first 6 months, but final postoperative CFT were not significantly different between the groups at 12 months. mo = month(s). ^*p < 0.05, student's T-test.

Table 1

Preoperative data

Values are presented as mean ± SD or n (%) unless otherwise indicated.

ELM = external limiting membrane; IS/OS = inner segment/outer segment junction; CFT = central foveal thickness; VMT = vitreomacular traction; MPH = macular pseudohole; BCVA = best corrected visual acuity.

^*Compared by Pearson's chi-squared test; ^†Compared by student's T-test; ^‡Compared by logistic regression analysis; ^§Compared by Fisher's exact test.

Table 2

Mean best corrected visual acuity (logMAR) changes

Values are presented as mean ± SD unless otherwise indicated.

^*Compared by student's T-test.

Table 3

Mean central foveal thickness (µm) changes

Values are presented as mean ± SD unless otherwise indicated.

^*Compared by student's T-test.

Table 4

Changes of central foveal thickness (µm) in different period

Values are presented as mean ± SD unless otherwise indicated.

^*Compared by student's T-test.

Table 5

Status of photoreceptor layer and external limiting membrane (ELM)

IS/OS = inner segment/outer segment junction.

Notes

This study was presented as a narration at the 117th Annual Meeting of the Korean Ophthalmological Society 2017.

^{Conflicts of Interest} The authors have no conflicts to disclose.

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