Öz
Purpose: To evaluate the safety and effectivity of limited vitrectomy in patients with epiretinal membrane. Methods: We included 58 consecutive patients who underwent epiretinal membrane surgery without performing a complete peripheral vitreous removal. The improvement in visual acuity, the incidence of retinal breaks and detachment; anatomical results and intraoperative and postoperative complications of this technique were evaluated. Results: The median visual acuity was 0.4 0.3-0.5 before the surgery, and it was 0.6 0.3-0.8 after the surgery p=0.016 . Prophylactic laser photocoagulation was performed in 14 24,13% patients during surgery. Retinal breaks and detachments did not occur in any of our patients. We did not observe proliferative vitreoretinopathy or surgery- related major complications in any patient. Conclusion: Limited vitrectomy without removing peripheral vitreous is safe and effective in idiopathic epiretinal membrane surgery. It reduces the risk of peripheral retinal breaks and retinal detachment.
Anahtar Kelimeler
Limited vitrectomy epiretinal membrane surgery pars plana vitrectomy retinal breaks retinal detachment
Kaynakça
- Mitchell P, Smith W, Chey T, Wang JJ, Chang A. Prevalence and associations of epiretinal membranes. The blue mountains eye study. Ophthalmology 1997;104:1033–40. [CrossRef]
- Ting FS, Kwok AK. Treatment of epiretinal membrane: an update. Hong Kong Med J 2005;11:496–502.
- Rizzo S, Belting C, Genovesi-Ebert F, di Bartolo E. Incidence of retinal detachment after small-incision, sutureless pars plana vitrectomy compared with conventional 20 gauge vitrectomy in macular hole and epiretinal membrane surgery. Retina 2010;30:1065–71. [CrossRef]
- Krishnan R, Tossounis C, Fung Yang Y. 20-gauge and 23-gauge phacovitrectomy for idiopathic macular holes: comparison of complications and long-term outcomes. Eye 2013;27:72–7. [CrossRef]
- Issa SA, Connor A, Habib M, Steel DHW. Comparison of retinal breaks observed during 23 gauge transconjunctival vitrectomy versus conventional 20 gauge surgery for proliferative diabetic retinopathy. Clin Ophthalmol 2011;20:109–14. [CrossRef]
- Nakano T, Uemura A, Sakamoto T. Incidence of iatrogenic peripheral retinal breaks in 23-gauge vitrectomy for macular diseases. Retina 2011;31:1997–2001. [CrossRef]
- Marie-Louise J, Philippakis E, Darugar A, Tadayoni R, Dupas B. Occurrence rate of retinal detachment after small gauge vitrectomy for idiopathic epiretinal membrane. Eye (Lond) 2017;31:1259–65. [CrossRef]
- Rahman R, Murray CD, Stephenson J. Risk factors for iatrogenic retinal breaks induced by separation of posterior hyaloid face during 23-gauge pars plana vitrectomy. Eye 2013;27:652–6. [CrossRef]
- Chung SE, Kim KH, Kang SW. Retinal breaks associated with the induction of posterior vitreous detachment. Am J Ophthalmol 2009;147:1012–6. [CrossRef]
- Yagi F, Takagi, Tomita G. Incidence and causes of iatrogenic retinal breaks in idiopathic macular hole and epiretinal membrane. Semin Ophthalmol 2014:29:66–9. [CrossRef]
- Tan HS, Mura M, de Smet MD. Iatrogenic retinal breaks in 25-gauge macular surgery. Am J Ophthalmol 2009;148:427–30.e1. [CrossRef]
- Guillaubey A, Malvitte L, Lafontine PO, Hubert I, Bron A, Berrod JP, Creuzot-Garcher C. Incidence of retinal detachment after macular surgery: a retirospective study of 634 cases. Br J Ophthalmol 2007;91:1327–30. [CrossRef]
- Grosso A, Panico C. Incidence of retinal detachment following 23-gauge vitrectomy in idiopathic epiretinal membrane surgery. Acta Ophthalmol 2011;89:e98. [CrossRef]
Öz
Amaç: Epiretinal membran nedeni ile vitreoretinal cerrahi uygulanan hastalarda sınırlı vitrektomi uygulamasının güvenliğinin ve etkinliğinin değerlendirilmesi Hastalar ve Yöntem: Sınırlı vitrektomi uygulanan epiretinal membranlı 58 hastanın bulguları değerlendirildi. Görme keskinliğindeki artış, operasyon sırasında oluşan periferik yırtıklar ve retina dekolmanı gelişimi sıklığı, anatomik sonuçlar, intraoperatif ve postoperatif komplikasyonlar değerlendirildi. Bulgular: Median görme keskinliği ameliyat öncesi 0.4 0.3-0.5 , ameliyat sonrası 0.6 0.3-0.8 olarak bulundu p=0.016 . Ondört hastaya 24,13% operasyon sırasında profilaktik laser fotokoagulasyon yapıldı. Hiç bir hastada operasyon sırasında retina yırtığı ve retina dekolmanı gelişmedi. Hiç bir hastada sınırlı vitrektomiye bağlı proliferatif vitreoretinopati ve komplikasyon oluşmadı. Sonuç: Periferik vitreusu temizlemden yapılan sınırlı vitrektomi, epiretinal membranı olan hastaların tedavisinde etkili ve güvenli bir yöntemdi. Bu yöntem hastalarda periferik retina yırtıkları ve retina dekolmanı riskini azaltmaktadır
Anahtar Kelimeler
Sınırlı vitrektomi epiretinal membran cerrahisi pars plana vitrektomi retina yırtıkları retina dekolmanı
Kaynakça
- Mitchell P, Smith W, Chey T, Wang JJ, Chang A. Prevalence and associations of epiretinal membranes. The blue mountains eye study. Ophthalmology 1997;104:1033–40. [CrossRef]
- Ting FS, Kwok AK. Treatment of epiretinal membrane: an update. Hong Kong Med J 2005;11:496–502.
- Rizzo S, Belting C, Genovesi-Ebert F, di Bartolo E. Incidence of retinal detachment after small-incision, sutureless pars plana vitrectomy compared with conventional 20 gauge vitrectomy in macular hole and epiretinal membrane surgery. Retina 2010;30:1065–71. [CrossRef]
- Krishnan R, Tossounis C, Fung Yang Y. 20-gauge and 23-gauge phacovitrectomy for idiopathic macular holes: comparison of complications and long-term outcomes. Eye 2013;27:72–7. [CrossRef]
- Issa SA, Connor A, Habib M, Steel DHW. Comparison of retinal breaks observed during 23 gauge transconjunctival vitrectomy versus conventional 20 gauge surgery for proliferative diabetic retinopathy. Clin Ophthalmol 2011;20:109–14. [CrossRef]
- Nakano T, Uemura A, Sakamoto T. Incidence of iatrogenic peripheral retinal breaks in 23-gauge vitrectomy for macular diseases. Retina 2011;31:1997–2001. [CrossRef]
- Marie-Louise J, Philippakis E, Darugar A, Tadayoni R, Dupas B. Occurrence rate of retinal detachment after small gauge vitrectomy for idiopathic epiretinal membrane. Eye (Lond) 2017;31:1259–65. [CrossRef]
- Rahman R, Murray CD, Stephenson J. Risk factors for iatrogenic retinal breaks induced by separation of posterior hyaloid face during 23-gauge pars plana vitrectomy. Eye 2013;27:652–6. [CrossRef]
- Chung SE, Kim KH, Kang SW. Retinal breaks associated with the induction of posterior vitreous detachment. Am J Ophthalmol 2009;147:1012–6. [CrossRef]
- Yagi F, Takagi, Tomita G. Incidence and causes of iatrogenic retinal breaks in idiopathic macular hole and epiretinal membrane. Semin Ophthalmol 2014:29:66–9. [CrossRef]
- Tan HS, Mura M, de Smet MD. Iatrogenic retinal breaks in 25-gauge macular surgery. Am J Ophthalmol 2009;148:427–30.e1. [CrossRef]
- Guillaubey A, Malvitte L, Lafontine PO, Hubert I, Bron A, Berrod JP, Creuzot-Garcher C. Incidence of retinal detachment after macular surgery: a retirospective study of 634 cases. Br J Ophthalmol 2007;91:1327–30. [CrossRef]
- Grosso A, Panico C. Incidence of retinal detachment following 23-gauge vitrectomy in idiopathic epiretinal membrane surgery. Acta Ophthalmol 2011;89:e98. [CrossRef]
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Bölüm | Research Article |
| Yazarlar | |
| Yayımlanma Tarihi | 1 Eylül 2019 |
| Yayımlandığı Sayı | Yıl 2019Sayı: 3 |