Xue Shuyue, Zhou Mingming, Chen Dong, Yu Bin, Cui Wei, Chen Nan
Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, 5 Yanerdao Road, Qingdao, 266071, China.
State Key Laboratory Cultivation Base, Shandong Key Laboratory of Eye Diseases, Qingdao, China.
Sci Rep. 2025 Jul 19;15(1):26265. doi: 10.1038/s41598-025-08410-7.
This study compared the efficacy of nonvitrectomizing vitreous surgery (NVS) and pars plana vitrectomy (PPV) for idiopathic epiretinal membrane by evaluating both the central macular thickness (CMT) and disorganization of retinal inner layers (DRIL), an indicator first used for structural assessment. Medical records of 117 patients (117 eyes; NVS: 54 eyes; PPV: 63 eyes) were retrospectively analyzed. Baseline best-corrected visual acuity (BCVA), CMT, and DRIL points showed no significant intergroup differences. Postoperatively, BCVA improved, whereas CMT and DRIL points decreased greatly at 1 and 6 months in both groups. While postoperative CMT and DRIL points did not differ significantly between groups, BCVA improvement was comparable at 1 month but obviously greater in the NVS group at 6 months. Eyes with no/mild DRIL had better visual prognoses than those with severe DRIL, though marked visual improvement occurred even in cases with severe DRIL. No ERM recurrence was observed. In conclusion, NVS, which simplifies the surgical procedure and preserves the vitreous integrity, can achieve non-inferior visual functional and retinal structural outcomes compared to PPV in the treatment of iERM.
本研究通过评估中心黄斑厚度（CMT）和视网膜内层结构紊乱（DRIL，一种首次用于结构评估的指标），比较了非玻璃体切除玻璃体手术（NVS）和玻璃体切除术（PPV）治疗特发性视网膜前膜的疗效。对117例患者（117只眼；NVS组：54只眼；PPV组：63只眼）的病历进行回顾性分析。基线最佳矫正视力（BCVA）、CMT和DRIL评分在组间无显著差异。术后，两组患者的BCVA均有所改善，而CMT和DRIL评分在术后1个月和6个月时均大幅下降。虽然术后两组间CMT和DRIL评分无显著差异，但BCVA改善情况在术后1个月时相当，而在术后6个月时NVS组明显更好。无/轻度DRIL的眼比重度DRIL的眼视觉预后更好，不过即使是重度DRIL的病例也有明显的视力改善。未观察到视网膜前膜复发。总之，NVS简化了手术操作并保留了玻璃体的完整性，在治疗特发性视网膜前膜方面，与PPV相比可实现非劣效的视觉功能和视网膜结构预后。
