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Limited Vitrectomy versus Complete Vitrectomy for Epiretinal Membranes: A Comparative Multicenter Trial.

ABSTRACT: Purpose:To evaluate whether limited vitrectomy is as effective as complete vitrectomy in eyes with epiretinal membrane (ERM) and to compare the surgical times and rates of complications. Methods:In this multicentre European study, data of eyes with ERM that underwent vitrectomy from January 2017 to July 2018 were analyzed retrospectively. In the limited vitrectomy group, a posterior vitreous detachment (PVD) was induced up till the equator as opposed to complete PVD induction till the vitreous base in the comparison group. Incidence of iatrogenic retinal breaks, retinal detachment, surgical time, and visual outcomes were compared between groups. Results:We included 139 eyes in the analysis with a mean age being 72.2?±?6.9 years. In this, sixty-five eyes (47%) underwent limited vitrectomy and 74 eyes (53%) underwent complete vitrectomy. Iatrogenic retinal tears were seen in both groups (5% in limited vitrectomy versus 7% in complete vitrectomy, p=0.49). Retinal detachment occurred in 2 eyes in the limited vitrectomy group (3%) compared to none in the complete vitrectomy group (p=0.22). Best-corrected visual acuity (BCVA) and central macular thickness improved significantly with no intergroup differences (p=0.18). Surgical time was significantly shorter in the limited vitrectomy group with 91% surgeries taking less than 1 hour compared to 71% in the complete vitrectomy group (p < 0.001). Conclusion:A limited vitrectomy is a time-efficient and effective surgical procedure for removal of epiretinal membrane with no additional complications.

SUBMITTER: Forlini M

PROVIDER: S-EPMC7603613 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Limited Vitrectomy versus Complete Vitrectomy for Epiretinal Membranes: A Comparative Multicenter Trial.

Forlini Matteo M Date Purva P D'Eliseo Domenico D Rossini Paolo P Bratu Adriana A Volinia Andrea A Neri Giovanni G Verdina Tommaso T Carbotti Maria Rosaria MR Cavallini Gian Maria GM Sborgia Luigi L Galeone Alessandra A Imburgia Aurelio A Mularoni Alessandro A Meduri Alessandro A

Journal of ophthalmology 20201020

<h4>Purpose</h4>To evaluate whether limited vitrectomy is as effective as complete vitrectomy in eyes with epiretinal membrane (ERM) and to compare the surgical times and rates of complications.<h4>Methods</h4>In this multicentre European study, data of eyes with ERM that underwent vitrectomy from January 2017 to July 2018 were analyzed retrospectively. In the limited vitrectomy group, a posterior vitreous detachment (PVD) was induced up till the equator as opposed to complete PVD induction till ...[more]

PMID: 33149943

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Project description:The aim of this study was to compare changes in refraction following lens-sparing vitrectomy between patients with rhegmatogenous retinal detachment (RRD) and epiretinal membrane (ERM) and to investigate factors associated with the change in refraction.We reviewed medical records of 49 eyes of 49 patients with RRD (53.6?±?7.8 years, mean?±?standard deviation) and 24 eyes of 24 patients with ERM (50.9?±?15.7 years) who underwent lens-sparing vitrectomy. Spherical equivalent refractive power was evaluated before and up to 18 months after surgery. The relationship between the change in refraction and several parameters was evaluated.A significant progressive myopic shift in refractive power was observed after vitrectomy in operated RRD and ERM eyes (P?<?0.001, P?=?0.016, respectively), with no significant difference in fellow eyes. The refraction values observed at ?3 and ?12 months following vitrectomy were significantly different as compared with those observed at baseline in the RRD group (P?<?0.001) and the ERM group (P?<?0.05), respectively. The change in refraction between the RRD and ERM groups was significant (P?=?0.030). The multiple linear regression analysis showed that only age was significantly correlated with the change in refraction in RRD (P?=?0.018) and ERM (P?<?0.001) groups. The change in refraction was significantly and positively correlated with age in RRD (r?=?-0.461, P?=?0.001) and ERM (r?=?-0.687, P?<?0.001) groups. Following lens-sparing vitrectomy, cataract surgery was performed on 30 eyes after 0.89?±?0.26 years in the RRD group and on 10 eyes after 1.11?±?0.14 years in the ERM group; there was a significant difference in time to cataract surgery between the groups (P?=?0.007). Kaplan-Meier survival analysis demonstrated that there was a significant difference in the rate of cataract surgeries between the RRD and ERM groups (P?=?0.022).Following lens-sparing vitrectomy for RRD and ERM, a progressive myopic shift in refraction owing to nuclear sclerosis was observed. Core vitrectomy itself would cause a myopic shift of refraction. The only risk factor associated with cataract progression following lens-sparing vitrectomy is age for both types of patients.

Dataset Information

Limited Vitrectomy versus Complete Vitrectomy for Epiretinal Membranes: A Comparative Multicenter Trial.

Publications

Limited Vitrectomy versus Complete Vitrectomy for Epiretinal Membranes: A Comparative Multicenter Trial.

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