THE EFFECT OF INTERNAL LIMITING MEMBRANE PEELING ON IDIOPATHIC EPIRETINAL MEMBRANE SURGERY, WITH A REVIEW OF THE LITERATURE
THE EFFECT OF INTERNAL LIMITING MEMBRANE PEELING ON IDIOPATHIC EPIRETINAL MEMBRANE SURGERY, WITH A REVIEW OF THE LITERATURE
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DOI：
10.1097/iae.0000000000001263
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发表时间：
2017-05-01
影响因子：
3.3
通讯作者：
Thompson, John T.
中科院分区：
文献类型：
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作者：
Schechet, Sidney A.;DeVience, Eva;Thompson, John T.
目的：通过比较最佳矫正视力（BCVA）、光学相干断层扫描中心黄斑厚度（CMT）变化、视网膜前膜（ERM）复发和是否需要再次手术来检查内界膜（ILM）去除对视网膜前膜（ERM）手术的影响。251例连续患者的回顾性研究（251只眼），由一名外科医生进行特发性ERM的睫状体平坦部玻璃体切除术，随访数据超过1年。在术前、术后3个月、1年、2年和末次访视时收集数据。结果：140只眼（55.8%）无内界膜剥离（非内界膜组），111只眼（44.2%）有内界膜剥离（内界膜组）。两组之间在年龄、性别、术前BCVA、术前眼内压、光学相干断层扫描的术前CMT和白内障状态方面无显著差异。ILM组的总随访时间为32.1个月，非ILM组为45.4个月（P = 0.002）。两组BCVA均有所改善。ILM组改善了12个早期治疗糖尿病视网膜病变研究字母，非ILM组改善了10.5个早期治疗糖尿病视网膜病变研究字母。最终BCVA（P = 0.18）或BCVA的总变化（P = 0.48）无显著差异。术前白内障状态不影响BCVA的总体变化，但最近一次访视时有晶状体眼与视力轻度丧失相关。两组的光学相干断层扫描外观均有所改善，ILM组的CMT减少了83 mm，非ILM组的CMT减少了110 mm。最终CMT无显著差异（P = 0.07）;然而，非ILM组的最终CMT往往较低。裂隙灯生物显微镜检查发现，ILM组2眼（1.8%）和非ILM组32眼（22.9%）有不同程度的ERM复发（P
Purpose: To examine the effect of internal limiting membrane (ILM) removal on epiretinal membrane (ERM) surgery by comparing best-corrected visual acuity (BCVA), optical coherence tomography central macular thickness (CMT) changes, ERM recurrence, and need for repeat surgery.Methods: Retrospective study of 251 consecutive patients (251 eyes) who underwent pars plana vitrectomy for idiopathic ERM by a single surgeon with over 1 year of follow-up data. Data were collected preoperatively and postoperatively at 3 months, 1 year, 2 years, and at the last visit. The ILM was not specifically removed in the earlier group of patients and was removed after staining of the ILM in the later group.Results: One hundred and forty eyes (55.8%) did not have an ILM peel (non-ILM group), and 111 eyes (44.2%) did have an ILM peel (ILM group). There were no significant differences between groups in age, gender, preoperative BCVA, preoperative intraocular pressure, preoperative CMT on optical coherence tomography, and cataract status. Total follow-up time for the ILM group was 32.1 months and 45.4 months for the non-ILM group (P = 0.002). Both groups had improvement in BCVA. The ILM group improved by 12 Early Treatment Diabetic Retinopathy Study letters and the non-ILM group improved by 10.5 Early Treatment Diabetic Retinopathy Study letters. There was no significant difference in the final BCVA (P = 0.18) or total change of BCVA (P = 0.48). Cataract status preoperatively did not affect the total change of BCVA, but being phakic at the most recent visit was associated with a slight loss of visual acuity. Both groups had improvement in optical coherence tomography appearance, for the CMT in the ILM group decreased by 83 mm and the CMT in the non-ILM group decreased by 110 mm. There was no significant difference in the final CMT (P = 0.07); however, the non-ILM group tended to have a lower final CMT. Some degree of ERM recurrence was detected by slit-lamp biomicroscopy in 2 eyes (1.8%) of the ILM group and in 32 eyes (22.9%) of the non-ILM group (P