J Korean Ophthalmol Soc.  2018 Aug;59(8):738-744. 10.3341/jkos.2018.59.8.738.

Intraoperative Foveal Traction in Patients with Epiretinal Membrane

• Jeon HM
• Chae SH
• Bang CW
• Lee MS
• Yoon HS

• KMID: 2418500
• DOI: http://doi.org/10.3341/jkos.2018.59.8.738

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.

Keyword

Idiopathic epiretinal membrane; Intraoperative foveal traction; Membrane peeling; Vitrectomy

MeSH Terms

Epiretinal Membrane*
Humans
Membranes
Observational Study
Outcome Assessment (Health Care)
Retrospective Studies
Tomography, Optical Coherence
Traction*
Visual Acuity
Vitrectomy

Figure

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  Figure 1 Schema of the retinal membrane peeling. A drawing shows foveal traction during membrane peeling.

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  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.

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