Tranos Paris, Koukoula Stavrenia, Charteris Davic G, Perganda Georgia, Vakalis Athanasios, Asteriadis Solon, Georgalas Ilias, Petrou Petros
Ophthalmica Centre, Thessaloniki, Greece.
Moorfields Eye Hospital, London, UK.
Br J Ophthalmol. 2017 Jun;101(6):719-724. doi: 10.1136/bjophthalmol-2016-309308. Epub 2016 Oct 7.
To compare the anatomical and functional outcomes after primary idiopathic epiretinal membrane (ERM) peeling with or without internal limiting membrane (ILM) peeling.
A two-centre randomised, controlled clinical trial with 12 months of follow-up.
One hundred and two eyes of 102 patients were included in the analysis and were randomised into two groups (ILM peeling (P) and non-ILM peeling (NP) group). Inclusion criteria were: Idiopathic ERM confirmed on optical coherence tomography, age ≥18 years, binocular distortion, best-corrected visual acuity (BCVA) ≤90 ETDRS letters, intraocular pressure ≤23 mm Hg and informed consent. The primary outcome measure was the mean change in the ETDRS distance BCVA at 12 months' follow-up for each group.
The mean change in distance BCVA at 12 months was 0.30±0.24 logMAR (15 ETDRS letters) in the P group and 0.31±0.23 logMAR (14 ETDRS letters) in the NP group, a change that was not statistically significant (p=0.84). No statistically significant differences were observed when comparing the changes in distance BCVA, the changes in metamorphopsia (Amsler grid) and the changes in central retinal thickness between the two groups at any of the time points studied.
Our analysis suggests that ILM peeling in idiopathic ERM surgery does not result in better visual improvement. The more frequent presence of an uninterrupted interdigitation zone in the P group did not result in a better functional outcome of our patients. No recurrent ERMs were noted in either group.
比较原发性特发性视网膜前膜（ERM）剥除联合或不联合内界膜（ILM）剥除后的解剖学和功能学结果。
一项为期12个月随访的双中心随机对照临床试验。
纳入102例患者的102只眼进行分析，并随机分为两组（ILM剥除组（P组）和非ILM剥除组（NP组））。纳入标准为：光学相干断层扫描确诊为特发性ERM，年龄≥18岁，双眼变形，最佳矫正视力（BCVA）≤90 ETDRS字母，眼压≤23 mmHg且签署知情同意书。主要观察指标为每组在随访12个月时ETDRS距离BCVA的平均变化。
P组在12个月时距离BCVA的平均变化为0.30±0.24 logMAR（15个ETDRS字母），NP组为0.31±0.23 logMAR（14个ETDRS字母），该变化无统计学意义（p = 0.84）。在研究的任何时间点比较两组之间距离BCVA的变化以及变形视（Amsler方格表）和中心视网膜厚度的变化时，均未观察到统计学上的显著差异。
我们的分析表明，特发性ERM手术中剥除ILM并不能带来更好的视力改善。P组中更频繁出现的连续指状交叉区并未使我们的患者获得更好的功能结果。两组均未发现复发性ERM。
