Clinical outcomes of double membrane peeling with or without simultaneous phacoemulsification/gas tamponade for vitreoretinal-interface-associated (VRI) disorders.

Abstract

The purpose of this study is to evaluate the clinical outcomes of double membrane (ERM & ILM) peeling and the effect of combined cataract surgery and SF6 gas injection in vitreoretinal interface (VRI) disorders. This is a retrospective interventional study. Seventy-two eyes with idiopathic vitreoretinal interface abnormalities that underwent 23 gauge pars plana vitrectomy with "double stain and double peel" technique were reviewed. SD-OCT was used to classify VRI disorders into following 4 groups: 44 in ERM type, 17 in VMTS type, 7 in macular pseudohole (MPH) type, and 4 in lamellar macular hole (LMH) type. ERM was a common association in all types. Mean preoperative BCVA improved from 0.58±0.14 logMAR to 0.27±0.16 logMAR units (p=0.001). Mean CFT reduced from 409.17±122.31µm preoperatively to 277.28±0.16µm postoperatively (p<0.0001). Among the VRI subtypes, visual improvement was significant except in LMH variety (ERM type, p=0.0029; VMTS type, p=0.0281; MPH type, p=0.05; and LMH type, p=0.7926). Mean change in CFT from baseline was least in LMH cases (p=0.0093). There was no significant difference in BCVA and CFT in the group who had combined phacovitrectomy versus pseudophakic group (p>0.05). Use of intraocular SF6 gas tamponade did not show any added benefits among the groups (p>0.05). Improvement in foveal contour was seen in all groups. Simultaneous removal of ILM along with ERM during surgery for VRI disorders helps in restoring normal foveal contour with a favorable visual outcome. Combined cataract extraction or use of intraocular SF6 gas injection does not affect the surgical results.