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Pars Plana Vitrectomy Combined With Internal Limiting Membrane Peeling In The Treatment of Epiretinal Membrane

Year 2010, Issue: 2, 85 - 88, 01.06.2010

Abdullah Özkırış

Abstract

AIM: To evaluate the outcomes of peeling of the internal limiting membrane ILM combined with pars plana vitrectomy in patients with epiretinal membrane ERM . Materials-Methods: The charts of 53 patients 63 eyes who had undergone PPV combined ILM peeling due to various reasons were retrospectively reviewed. There were 23 men and 30 women, and the mean age of the patients was 59.5 years. In all patients, a complete ophthalmological examination including visual acuity determination, slit-lamp biomicroscopy, intraocular pressure IOP measurement, fundus examination and fundus fluorescein angiography was performed before and after surgery.Results: Visual acuity averaged at 20/200 before surgery. The mean follow-up time was 14.3 months and vision acuity improved or remained unchanged in 96.8 % of eyes after surgery. The average improvement in visual acuity was 3.0 lines. The most common complication was cataract formation after surgery. Postoperative rhegmatogenous retinal detachment was observed in one eye 1.5% . No ERM recurrence was observed during the follow-up period.Conclusion: We observed that PPV combined with ILM peeling is a safe and effective procedure and increases the visual acuity

Keywords

epiretinal membrane pars plana vitrectomy internal limiting membran peeling

References

  • Roth AM, Foos RY. Surface wrinkling retinopathy in eyes enucleated at autopsy. Trans Am Acad Ophthalmol Otolaryngol 1971; 75: 1047-1058.
  • Foos RY. Vitreoretinal juncture; epiretinal membranes and vitreous. Invest Ophthalmol Vis Sci 1977; 16: 416-422.
  • Appiah AP, Hirose T. Secondary causes of premacular fibrosis. Ophthalmology 1989;96: 389-392.
  • King L, Joshi JS, Wirostko WJ. Epiretinal membranes. In: Macular Surgery Eds: Mercado HQ.,Alfaro III DV., Liggett PE, Tano Y., de Juan E. Lippincott Williams&Wilkinon, Philadelphia. 2000; Ch.14: 170-178.
  • Avcı R, Yıldız M, Şimşek Ş, Kaderli B. İdiyopatik makula deliklerinin tedavisinde indosiyanin yeşili yardımı ile retina iç limitan membranın soyulması. Retina Vitreus 2005;13:13-17.
  • Park DW, Dugel PU, Garda J, et al. Macular pucker removal with and without internal limiting membrane peeling: pilot study. Ophthalmology 2003; 110: 62-64.
  • Sorcinelli R. Surgical management of epiretinal membrane with indocyanine-green-assisted peeling. Ophthalmologica 2003;217: 107-110.
  • Smiddy WE, Maguire AM, Green WR, et al. Idiopathic epiretinal membranes. Ultrastructural characteristics and clinicopathologic correlation. Ophthalmology 1989; 96: 811-820.
  • Karabaş VL, Özkan B, Ö, Çağlar Y. Epiretinal membranlarda etyoloji ve vitreoretinal cerrahi sonuçlarımız. Retina Vitreus 2006;14:193-196.
  • Burke JM, Smith JM. Retinal proliferation in response to vitreous hemoglobin or iron. Invest Ophthalmol Vis Sci 1981; 20: 582-592.
  • Akar A, Arvas S, Kızılkaya M, Özkan Ş. Makula önü membranların cerrahi tedavi sonuçları. T Oft Gaz 2002;32:256-262.
  • Öztürkmen C, Eldem B, Kadayıfçılar S. Epiretinal membranlarda kilinik özellikler, izlem ve cerrahi sonuçları. T Oft Gaz 2003; 33:34-38.
  • Morris R, Witherspoon CD, Kuhn F, et al. Internal limiting membrane maculorhexis for traction maculopathy. Vitreoret Surg Technol 1997; 8:1-4.
  • De Bustros S, Thompson JT, Michels RG, Rice TA, Glaser BM. Vitrectomy for idiopathic epiretinal membranes causing macular pucker. Br J Ophthalmol 1988;72:692-695.
  • Rodrigues EB, Meyer CH, Schmidt JC, Kroll P. Surgical management of epiretinal membrane with indocyanine-greenassisted peeling. Ophthalmologica 2004; 218: 73-74.
  • Farah ME, Maia M, Rodrigues EB. Dyes in ocular surgery: principles for use in chromovitrectomy. Am J Ophthalmol 2009;148:332-40.
  • Rodrigues EB, Costa EF, Penha FM, et al. The use of vital dyes in ocular surgery. Surv Ophthalmol 2009;54:576-617.
  • Haritoglou C, Priglinger S, Gandorfer A, Welge-Lussen U, Kampik A. Histology of the vitreoretinal interface after indocyanine green staining of the ILM, with illumination using a halogen and xenon light source. Invest Ophthalmol Vis Sci 2005;46:1468–1472.
  • Gandorfer A, Haritoglou C, Gass CA, Ulbig MW, Kampik A. Indocyanine greenassisted peeling of the internal limiting membrane may cause retinal damage. Am J Ophthalmol 2001; 132: 431-433.
  • Rezai KA, Farrokh-Siar L, Ernest JT, van Seventer GA. Indocyanine gren induces apoptosis in human retinal pigment epithelial cells. Am J Ophthalmol 2004; 137: 931-933.
  • Uemura A, Kanda S, Sakamoto Y, Kita H. Visual field defects after uneventful vitrectomy for epiretinal membrane with indocyanine green-assisted internal limiting membrane peeling. Am J Ophthalmol 2003;136: 252-257.
  • Li K, Wong D, Hiscott P, Stanga P, Groenewald C, McGalliard J. Trypan blue staining of internal limiting membrane and epiretinal membrane during vitrectomy. Br J Ophthalmol 2003;87:216-219.
  • Çakır M, Çekiç O, Yılmaz B, Bayraktar Ş, Yılmaz ÖF. Pars plana vitrektomide tripan mavisi yardımıyla idiopatik membran soyulması. T Oft Gaz 2008;38:406-411.
  • Kwok AK, Yeung CK, Lai TY, Chan KP, Pang CP. Effects of trypan blue on cell viability and gene expression in human retinal pigment epithelial cells. Br J Ophthalmol 2004;88:1590-1594.
  • Schadlu R, Tehrani S, Shah GK, Prasad AG. Long-term follow-up results of ILM peeling during vitrectomy surgery for premacular fibrosis. Retina 2008;28:853-57.
  • Enaida H, Hisatomi T, Hata Y, et al. Brilliant blue G selectively stains the internal limiting membrane/brilliant blue G-assisted membrane peeling. Retina 2006;26:631-6.

Epiretinal Membran Tedavisinde Pars Plana Vitrektomi ile Kombine İnternal Limitan Membran Soyulması

Year 2010, Issue: 2, 85 - 88, 01.06.2010

Abdullah Özkırış

Abstract

Amaç: Epiretinal membranlı ERM olgularda internal limitan membran ILM soyulması ile kombine pars plana vitrektomi PPV sonuçlarının değerlendirilmesi. Metod: Değişik nedenlere bağlı epiretinal membran nedeniyle PPV ile kombine ILM soyulması uygulanan 53 olgunun 63 göz dosyaları retrospektif olarak incelendi. Olguların 23’ü erkek, 30’u bayan olup ortalama yaşları 59.5 yıl idi. Tüm olgularda cerrahi öncesi ve sonrası görme keskinliği, slit-lamp biomikroskopi, göz içi basıncı GİB ölçümü, fundus muayenesi ve fundus floresein anjiografi FFA içeren tam bir oftalmolojik muayene yapıldı. Bulgular: Cerrahi öncesi ortalama görme keskinliği 20/200 idi. Ortalama takip süresi 14.3 ay olup cerrahi sonrası görme artışı veya aynı görme keskinliği %96.8 olguda saptandı. Ortalama görme artışı 3.0 sıra olarak saptandı. Cerrahi sonrası en sık gözlenen komplikasyon katarakt gelişimi idi. Postoperatif dönemde bir gözde %1.5 regmatojen retina dekolmanı gelişti. Hiçbir olguda takip süresi boyunca nüks ERM gelişimi gözlenmedi. Sonuç: ERM’lı olgularda, PPV ile birlikte ILM soyulmasının etkin, güvenilir bir yöntem olduğunu ve görme keskinliğini arttırdığını gözlemledik

Keywords

epiretinal membran pars plana vitrektomi internal limitan membran soyulması

References

  • Roth AM, Foos RY. Surface wrinkling retinopathy in eyes enucleated at autopsy. Trans Am Acad Ophthalmol Otolaryngol 1971; 75: 1047-1058.
  • Foos RY. Vitreoretinal juncture; epiretinal membranes and vitreous. Invest Ophthalmol Vis Sci 1977; 16: 416-422.
  • Appiah AP, Hirose T. Secondary causes of premacular fibrosis. Ophthalmology 1989;96: 389-392.
  • King L, Joshi JS, Wirostko WJ. Epiretinal membranes. In: Macular Surgery Eds: Mercado HQ.,Alfaro III DV., Liggett PE, Tano Y., de Juan E. Lippincott Williams&Wilkinon, Philadelphia. 2000; Ch.14: 170-178.
  • Avcı R, Yıldız M, Şimşek Ş, Kaderli B. İdiyopatik makula deliklerinin tedavisinde indosiyanin yeşili yardımı ile retina iç limitan membranın soyulması. Retina Vitreus 2005;13:13-17.
  • Park DW, Dugel PU, Garda J, et al. Macular pucker removal with and without internal limiting membrane peeling: pilot study. Ophthalmology 2003; 110: 62-64.
  • Sorcinelli R. Surgical management of epiretinal membrane with indocyanine-green-assisted peeling. Ophthalmologica 2003;217: 107-110.
  • Smiddy WE, Maguire AM, Green WR, et al. Idiopathic epiretinal membranes. Ultrastructural characteristics and clinicopathologic correlation. Ophthalmology 1989; 96: 811-820.
  • Karabaş VL, Özkan B, Ö, Çağlar Y. Epiretinal membranlarda etyoloji ve vitreoretinal cerrahi sonuçlarımız. Retina Vitreus 2006;14:193-196.
  • Burke JM, Smith JM. Retinal proliferation in response to vitreous hemoglobin or iron. Invest Ophthalmol Vis Sci 1981; 20: 582-592.
  • Akar A, Arvas S, Kızılkaya M, Özkan Ş. Makula önü membranların cerrahi tedavi sonuçları. T Oft Gaz 2002;32:256-262.
  • Öztürkmen C, Eldem B, Kadayıfçılar S. Epiretinal membranlarda kilinik özellikler, izlem ve cerrahi sonuçları. T Oft Gaz 2003; 33:34-38.
  • Morris R, Witherspoon CD, Kuhn F, et al. Internal limiting membrane maculorhexis for traction maculopathy. Vitreoret Surg Technol 1997; 8:1-4.
  • De Bustros S, Thompson JT, Michels RG, Rice TA, Glaser BM. Vitrectomy for idiopathic epiretinal membranes causing macular pucker. Br J Ophthalmol 1988;72:692-695.
  • Rodrigues EB, Meyer CH, Schmidt JC, Kroll P. Surgical management of epiretinal membrane with indocyanine-greenassisted peeling. Ophthalmologica 2004; 218: 73-74.
  • Farah ME, Maia M, Rodrigues EB. Dyes in ocular surgery: principles for use in chromovitrectomy. Am J Ophthalmol 2009;148:332-40.
  • Rodrigues EB, Costa EF, Penha FM, et al. The use of vital dyes in ocular surgery. Surv Ophthalmol 2009;54:576-617.
  • Haritoglou C, Priglinger S, Gandorfer A, Welge-Lussen U, Kampik A. Histology of the vitreoretinal interface after indocyanine green staining of the ILM, with illumination using a halogen and xenon light source. Invest Ophthalmol Vis Sci 2005;46:1468–1472.
  • Gandorfer A, Haritoglou C, Gass CA, Ulbig MW, Kampik A. Indocyanine greenassisted peeling of the internal limiting membrane may cause retinal damage. Am J Ophthalmol 2001; 132: 431-433.
  • Rezai KA, Farrokh-Siar L, Ernest JT, van Seventer GA. Indocyanine gren induces apoptosis in human retinal pigment epithelial cells. Am J Ophthalmol 2004; 137: 931-933.
  • Uemura A, Kanda S, Sakamoto Y, Kita H. Visual field defects after uneventful vitrectomy for epiretinal membrane with indocyanine green-assisted internal limiting membrane peeling. Am J Ophthalmol 2003;136: 252-257.
  • Li K, Wong D, Hiscott P, Stanga P, Groenewald C, McGalliard J. Trypan blue staining of internal limiting membrane and epiretinal membrane during vitrectomy. Br J Ophthalmol 2003;87:216-219.
  • Çakır M, Çekiç O, Yılmaz B, Bayraktar Ş, Yılmaz ÖF. Pars plana vitrektomide tripan mavisi yardımıyla idiopatik membran soyulması. T Oft Gaz 2008;38:406-411.
  • Kwok AK, Yeung CK, Lai TY, Chan KP, Pang CP. Effects of trypan blue on cell viability and gene expression in human retinal pigment epithelial cells. Br J Ophthalmol 2004;88:1590-1594.
  • Schadlu R, Tehrani S, Shah GK, Prasad AG. Long-term follow-up results of ILM peeling during vitrectomy surgery for premacular fibrosis. Retina 2008;28:853-57.
  • Enaida H, Hisatomi T, Hata Y, et al. Brilliant blue G selectively stains the internal limiting membrane/brilliant blue G-assisted membrane peeling. Retina 2006;26:631-6.
There are 26 citations in total.

Details

Primary Language Turkish
Journal Section Research Article
Authors

Abdullah Özkırış

Publication Date June 1, 2010
Published in Issue Year 2010Issue: 2

Cite

EndNote Özkırış A (June 1, 2010) Epiretinal Membran Tedavisinde Pars Plana Vitrektomi ile Kombine İnternal Limitan Membran Soyulması. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 2 85–88.