Evaluation of Chandelier Assisted Pars Plana Vitrectomy for Management of Epiretinal Membranes

Abstract

Background: ERM is a vision affecting disorder, frequently developed secondary to advanced PDR. DR remains one of the leading causes of legal blindness in the working- age population. Aim of the work: evaluation the safety, efficacy and feasibility of the chandelier assisted PPV for management of fibro-vascular membranes. Patients and methods: 43 eyes in 36 patients presented with ERM of different etiologies. After full ophthalmic examination, all patients underwent chandelier assisted PPV with silicone oil or gas tamponade without or with phacoemulsification and posterior chamber IOL implantation. Results: Combined phacoemulsification and PPV was done in 12 cases (27.9%), 2 cases were Pseudophakic while lens sparing PPV was done in 29 cases (67.4%). Complete ERM removal was achieved in 38 cases (88.4%) and incompletely removed in five cases (11.6%). Residual tractional RD was observed in two cases (4.7%). Iatrogenic breaks were occurred in 7 cases (16.3%). Endo-laser photocoagulation was done in 33 cases (76.7%). Silicone oil tamponade was used in 33 cases (76.7%), gas in 8 cases (18.6%) while air tamponade was used in 2 cases (4.7%). There was improvement of BCVA in 31 cases (72.1 %), while 10 cases (23.3%) remained the same and worsened in 2 eyes (4.7%) due to recurrent proliferation, consecutive optic disc atrophy and development of neo-vascular glaucoma. Conclusion: Chandelier assisted bimanual PPV is an effective, safe and an attainable technique for management of ERM, learning curve with this technique and coast benefit ratio may be considered.