Luan Rong, Liu Boshi, Cai Bincui, Gong Yi, Li Xiaorong
Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin 384300, China.
Retina. 2024 Oct 3. doi: 10.1097/IAE.0000000000004282.
To describe a novel surgical approach for treating patients diagnosed with severe idiopathic epiretinal membranes (iERM) featuring ectopic intrafoveal layers (EIFL).
A retrospective, interventional case series was conducted involving eight cases of iERM with EIFL. The technique involved a 27-gauge vitrectomy, removal of all vitreous adhesions, and injection of approximately 100μl sub-retinal balanced salt solution (BSS) using a 41-gauge subretinal needle, creating 3-4 localized bleb-like elevations around the folded retina to loosen it.
Vision improved significantly from a preoperative mean best-corrected visual acuity (BCVA) LogMAR of 0.72 (20/105) to 0.46 (20/58) at 1 week, 0.29 (20/40) (P = 0.016) at 1 month, and 0.28 (20/38) (P = 0.031) at the last follow-up. Central macular thickness (CMT) improved from a preoperative mean of 567.5 µm to 395.5 µm (P < 0.001) at 1 week, 377.38 µm (P < 0.001) at 1 month, and 381.50 µm (P < 0.001) at the last follow-up. No significant complications were observed.
The novel technique combining vitrectomy with subretinal BSS injection has demonstrated significant visual and anatomical efficacy in treating severe iERM. This approach can rapidly enhance BCVA and downgrad the EIFL Stage. Both anatomical and functional success can be achieved in this small series.
描述一种用于治疗被诊断为具有异位性黄斑内层次（EIFL）的严重特发性视网膜前膜（iERM）患者的新型手术方法。
进行了一项回顾性介入病例系列研究，纳入了8例患有EIFL的iERM患者。该技术包括27G玻璃体切除术，清除所有玻璃体粘连，并使用41G视网膜下针注射约100μl视网膜下平衡盐溶液（BSS），在折叠的视网膜周围形成3 - 4个局部泡状隆起以使其松解。
视力从术前平均最佳矫正视力（BCVA）LogMAR 0.72（20/105）显著改善，1周时为0.46（20/58），1个月时为0.29（20/40）（P = 0.016），最后一次随访时为0.28（20/38）（P = 0.031）。中心黄斑厚度（CMT）从术前平均567.5 µm改善至1周时的395.5 µm（P < 0.001），1个月时为377.38 µm（P < 0.001），最后一次随访时为381.50 µm（P < 0.001）。未观察到明显并发症。
玻璃体切除术与视网膜下BSS注射相结合的新技术在治疗严重iERM方面已显示出显著的视觉和解剖学疗效。这种方法可以快速提高BCVA并降低EIFL分期。在这个小系列研究中可以实现解剖学和功能上的成功。
