Wei Qingquan, Cai Chunyang, Yi Lan, Li Meiling, Zhang Wufeng, Chen Jili, Qiu Qinghua
Department of Ophthalmology, Tong Ren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.
Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.
Ther Clin Risk Manag. 2025 Mar 24;21:407-413. doi: 10.2147/TCRM.S500766. eCollection 2025.
This study aimed to assess a new three-phase method's efficacy and safety in treating idiopathic macular epiretinal membrane (ERM).
The novel technique involved a precise sequence: flap creation - wide margin- extensive peeling. Following the pars plana vitrectomy (PPV), to locate the epiretinal membrane, we stained the internal limiting membrane (ILM) with indocyanine green (ICG), using the stained ILM beneath as a guide to initiate the ERM flap. To minimize the force required for membrane peeling and traction on the underlying retina, we utilized a curved DSP scraper to form a wide-margin parallel arc along the inner aspect of the vascular arcade from the nasal to temporal side. Subsequently, the wide margin of the ERM was grasped tightly with ILM forceps, and traction was applied towards the central macular area to peel off the entire membrane. Finally, ICG staining was applied to ensure that the ERM was completely removed. The technique requires precise mastery of the three-step surgical skills and proficient use of specialized instruments.
In a sample of 55 cases, the surgery achieved significant treatment outcomes. All surgeries were successfully performed with an average duration of 4.23±0.34 minutes for ERM peeling. At the 12-month postoperative follow-up, the mean logarithm of the minimum angle of resolution best-corrected visual acuity (BCVA) significantly improved from 4.74±0.30 to 4.27±0.34. The average central macular thickness (CMT) significantly decreased from 503.64±111.88μm to 353.38±72.64μm. There are no intraoperative or postoperative complications and there was no recurrence.
The novel technique is a fast, simple, effective and safe surgical technique for treating idiopathic ERM. It significantly improves visual outcomes and reduces the occurrence of complications and recurrence.
本研究旨在评估一种新的三阶段方法治疗特发性黄斑视网膜前膜（ERM）的疗效和安全性。
这项新技术涉及一个精确的顺序：制作瓣 - 宽边缘 - 广泛剥离。在进行玻璃体切割术（PPV）后，为了定位视网膜前膜，我们用吲哚菁绿（ICG）对视网膜内界膜（ILM）进行染色，以染色的下方ILM为引导来启动ERM瓣。为了最小化膜剥离所需的力以及对下方视网膜的牵拉，我们使用弯曲的DSP刮匙沿着血管弓内侧从鼻侧到颞侧形成一个宽边缘平行弧。随后，用ILM镊紧紧抓住ERM的宽边缘，并向黄斑中心区域施加牵引力以剥除整个膜。最后，应用ICG染色以确保ERM被完全去除。该技术需要精确掌握这三个步骤的手术技巧并熟练使用专用器械。
在55例样本中，手术取得了显著的治疗效果。所有手术均成功完成，ERM剥离的平均持续时间为4.23±0.34分钟。术后12个月随访时，最佳矫正视力（BCVA）的最小分辨角对数均值从4.74±0.30显著提高到4.27±0.34。平均中心黄斑厚度（CMT）从503.64±111.88μm显著降至353.38±72.64μm。术中及术后均无并发症，也无复发情况。
该新技术是一种治疗特发性ERM的快速、简单、有效且安全的手术技术。它显著改善了视觉效果，减少了并发症和复发的发生。
