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孔源性视网膜脱离(RRD)手术中联合内界膜(ILM)剥除在预防术后视网膜前膜(ERM)形成中的作用。

Role of Concomitant Internal Limiting Membrane (ILM) Peeling During Rhegmatogenous Retinal Detachment (RRD) Surgery in Preventing Postoperative Epiretinal Membrane (ERM) Formation.

作者信息

Mahmood Syed Asaad, Rizvi Syed Fawad, Khan Burhan Abdul Majid, Khan Tanweer Hasan

机构信息

Dr. Syed Asaad Mahmood, FCPS (Ophth) Ophthalmologist, LRBT Tertiary Eye Care Hospital, Korangi 2 ½, Karachi, Pakistan.

Dr. Syed Fawad Rizvi, FCPS (Ophth) Chief Consultant Ophthalmologist, LRBT Tertiary Eye Care Hospital, Korangi 2 ½, Karachi, Pakistan.

出版信息

Pak J Med Sci. 2021 May-Jun;37(3):651-656. doi: 10.12669/pjms.37.3.3576.

Abstract

OBJECTIVE

To investigate the role of concomitant Internal Limiting Membrane (ILM) peeling during surgery for macula off Rhegmatogenous Retinal Detachment (RRD) in preventing postoperative Epiretinal Membrane (ERM) formation; and its effect on the visual acuity.

METHODS

This was a prospective, quasi-experimental study conducted from August 2018 to July 2019 at LRBT Tertiary Eye Care hospital, Karachi. Fifty-six patients with macula off RRD were divided into groups A (with ILM peeling) and B (without ILM peeling) via non-probability convenience sampling. All patients underwent standard 3 ports pars plana vitrectomy with silicon oil tamponade. In Group-A, ILM was stained using 0.5% ICG. Patients were evaluated clinically and by spectral domain optical coherence tomography (SD-OCT), pre- and post-operatively. Main outcomes recorded were best corrected visual acuity (BCVA) and occurrence of ERM on SD-OCT.

RESULTS

There were 26 patients in Group-A and 30 patients in Group-B. At six months' follow-up, ERM had not developed in any case in Group-A compared to five patients (16.7%) in Group-B. There was no statistical difference in mean BCVA change from baseline.

CONCLUSION

ILM peeling during vitrectomy for RRD prevents the formation of macular ERM post-operatively. This may reduce the need of a second vitrectomy. However, visual outcomes were comparable to the non-ILM peeling vitrectomy.

摘要

目的

探讨在孔源性视网膜脱离(RRD)黄斑脱离手术中同期行内界膜(ILM)剥除术对预防术后视网膜前膜(ERM)形成的作用及其对视力的影响。

方法

这是一项前瞻性、准实验性研究,于2018年8月至2019年7月在卡拉奇的LRBT三级眼科医院进行。通过非概率便利抽样将56例RRD黄斑脱离患者分为A组(行ILM剥除术)和B组(不行ILM剥除术)。所有患者均接受标准的三通道玻璃体切除术联合硅油填充。A组使用0.5%吲哚菁绿(ICG)对ILM进行染色。术前和术后对患者进行临床评估及光谱域光学相干断层扫描(SD-OCT)检查。记录的主要结局指标为最佳矫正视力(BCVA)和SD-OCT上ERM的发生情况。

结果

A组26例患者,B组30例患者。随访6个月时,A组无一例发生ERM,而B组有5例(16.7%)发生。平均BCVA较基线的变化无统计学差异。

结论

RRD玻璃体切除术中行ILM剥除术可预防术后黄斑区ERM形成。这可能减少二次玻璃体切除术的需求。然而,视力结局与不行ILM剥除术的玻璃体切除术相当。

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ILM peeling in rhegmatogenous retinal detachment; does it improve the outcome?孔源性视网膜脱离中的内界膜剥除术;它能改善治疗效果吗?
Graefes Arch Clin Exp Ophthalmol. 2018 Feb;256(2):247-248. doi: 10.1007/s00417-017-3876-6. Epub 2017 Dec 27.

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