SURGICAL OUTCOMES IN PATIENTS WITH MACULAR PUCKER AND GOOD PREOPERATIVE VISUAL ACUITY AFTER VITRECTOMY WITH MEMBRANE PEELING.

MedStar author(s):
Citation: Retina. 35(9):1817-21, 2015 Sep.PMID: 25923959Institution: MedStar Washington Hospital CenterDepartment: OphthalmologyForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Epiretinal Membrane/pp [Physiopathology] | *Epiretinal Membrane/su [Surgery] | *Visual Acuity/ph [Physiology] | *Vitrectomy | Aged | Cataract/et [Etiology] | Female | Humans | Macular Edema/et [Etiology] | Male | Microsurgery | Postoperative Complications | Retrospective StudiesYear: 2015Local holdings: Available online from MWHC library: 2001 - present, Available in print through MWHC library: 1999 - 2006ISSN:
  • 0275-004X
Name of journal: Retina (Philadelphia, Pa.)Abstract: CONCLUSION: Pars plana vitrectomy is both efficacious and safe an option for patients with ERMs and good preoperative vision. Eyes with an ERM and vision 20/50 or better had a statistically significant improvement in the final visual outcome after small-gauge pars plana vitrectomy surgery. As with large-gauge vitrectomy, cataract formation occurred in most phakic eyes within the first year after surgery.METHODS: Retrospective chart review of eyes undergoing small-gauge pars plana vitrectomy for ERM. Inclusion criterion was impaired visual acuity (20/50 or better) due to ERM. Exclusion criteria were preoperative visual acuity of 20/60 or worse, previous surgery (other than uncomplicated cataract surgery), and any documented evidence of macular or corneal disease that would limit visual potential. The main outcome measure was final visual acuity. Secondary outcomes included the role of internal limiting membrane peeling, and the effect of preoperative cystoid macular edema and internal limiting membrane peeling on visual acuity.PURPOSE: To evaluate whether patients with macular pucker (epiretinal membrane [ERM]) and good preoperative visual acuity (20/50 or better) benefit from small-gauge pars plana vitrectomy with membrane peeling.RESULTS: One hundred and forty eyes met inclusion criteria of which 94% underwent 25-gauge vitrectomy (remainder had 23-gauge). There was a statistically significant improvement in final vision with the mean preoperative visual acuity of 0.305 logMAR (20/40) and 1-year visual acuity of 0.250 logMAR (20/35) (P = 0.0167). Cataract formation in phakic patients had a significant effect on the final visual outcome. Fifty-six of 63 patients (89%) in the phakic cohort developed a visually significant cataract by study end. The mean time to recommendation of cataract surgery was 8.4 months. Thirty-eight eyes (27%) had preoperative cystoid macular edema. Fifty-nine eyes (42%) underwent internal limiting membrane peeling. Neither one of these secondary outcome measures had a significant effect on the final visual outcome.All authors: Lipscomb P, Melamud A, Reilly G, Toussaint BFiscal year: FY2016Digital Object Identifier: Date added to catalog: 2016-05-24
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Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 25923959 Available 25923959

Available online from MWHC library: 2001 - present, Available in print through MWHC library: 1999 - 2006

CONCLUSION: Pars plana vitrectomy is both efficacious and safe an option for patients with ERMs and good preoperative vision. Eyes with an ERM and vision 20/50 or better had a statistically significant improvement in the final visual outcome after small-gauge pars plana vitrectomy surgery. As with large-gauge vitrectomy, cataract formation occurred in most phakic eyes within the first year after surgery.

METHODS: Retrospective chart review of eyes undergoing small-gauge pars plana vitrectomy for ERM. Inclusion criterion was impaired visual acuity (20/50 or better) due to ERM. Exclusion criteria were preoperative visual acuity of 20/60 or worse, previous surgery (other than uncomplicated cataract surgery), and any documented evidence of macular or corneal disease that would limit visual potential. The main outcome measure was final visual acuity. Secondary outcomes included the role of internal limiting membrane peeling, and the effect of preoperative cystoid macular edema and internal limiting membrane peeling on visual acuity.

PURPOSE: To evaluate whether patients with macular pucker (epiretinal membrane [ERM]) and good preoperative visual acuity (20/50 or better) benefit from small-gauge pars plana vitrectomy with membrane peeling.

RESULTS: One hundred and forty eyes met inclusion criteria of which 94% underwent 25-gauge vitrectomy (remainder had 23-gauge). There was a statistically significant improvement in final vision with the mean preoperative visual acuity of 0.305 logMAR (20/40) and 1-year visual acuity of 0.250 logMAR (20/35) (P = 0.0167). Cataract formation in phakic patients had a significant effect on the final visual outcome. Fifty-six of 63 patients (89%) in the phakic cohort developed a visually significant cataract by study end. The mean time to recommendation of cataract surgery was 8.4 months. Thirty-eight eyes (27%) had preoperative cystoid macular edema. Fifty-nine eyes (42%) underwent internal limiting membrane peeling. Neither one of these secondary outcome measures had a significant effect on the final visual outcome.

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