Idiopathic macular epiretinal membrane surgery with simultaneous internal limiting membrane peeling. The experience of the Fribourg Eye Clinic

Gd Panos,Gottrau De

doi:10.4414/smw.2013.13876

Abstract

To evaluate the visual and anatomical outcomes following idiopathic macular epiretinal membrane (ERM) removal. A retrospective study of 30 eyes operated for idiopathic ERM was conducted. Pars plana vitrectomy was combined with ERM removal and indocyanine green (ICG) assisted internal limiting membrane (ILM) peeling. Mean preoperative best corrected visual acuity (BCVA) was 0.4 logMAR (0.4 in decimal units), whereas mean postoperative BCVA was 0.26 logMAR (0.6 in decimal units). Mean preoperative foveal thickness was 392 μm, whereas mean postoperative foveal thickness was 305 μm. A statistically significant difference was observed between preoperative and postoperative BCVA (p <0.001, Student's t-test). Optical coherence tomography (OCT) measurement of postoperative foveal thickness revealed a significant decrease in thickness (p <0.0001, Student's t-test), however, no correlation was observed between postoperative BCVA and postoperative foveal thickness (Pearson's correlation coefficient, r = 0.228; p = 0.22). Although significant visual acuity improvement and anatomical recovery was detected after idiopathic ERM removal, full restoration of foveal thickness was not achieved in the majority of cases.

Highlights

Macular epiretinal membrane (ERM) proliferation seems to be frequent in patients over 50 years of age, increasing from 2% at 50 years to 20% at 75 years
Optical coherence tomography (OCT) measurement of postoperative foveal thickness revealed a significant decrease in thickness (p
CONCLUSIONS: significant visual acuity improvement and anatomical recovery was detected after idiopathic ERM removal, full restoration of foveal thickness was not achieved in the majority of cases

Summary

Introduction

Macular epiretinal membrane (ERM) proliferation seems to be frequent in patients over 50 years of age, increasing from 2% at 50 years to 20% at 75 years. It is bilateral in 10% to 20% of the cases [1, 2]. Retinal ILM peeling is facilitated by indocyanine green (ICG) staining. In an autopsy study on human cadaveric eyes, ICG contact with the retinal surface resulted in bright green staining of the ILM, facilitating the ILM peeling by providing a stark contrast between the stained ILM and the unstained retina [9]. The purpose of our study was to evaluate the functional and anatomical outcomes following ERM removal with simultaneous ILM peeling

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Conclusion