Mahmood Syed Asaad, Rizvi Syed Fawad, Khan Burhan Abdul Majid, Khan Tanweer Hasan
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.
Pak J Med Sci. 2021 May-Jun;37(3):651-656. doi: 10.12669/pjms.37.3.3576.
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.
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.
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.
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.
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。
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。
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。
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。