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David Dyer, William Anderson, Michael Ellis; 12 Month Follow-up of Epiretinal Membranectomy. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3344.
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To assess the long-term effectiveness of an epiretinal membranectomy (ERM) surgery and analyze how differences in surgical protocol and demographics affect visual acuity and center point thickness outcomes.
A retrospective chart review of cases indicating epiretinal membranectomy surgery with a follow-up of at least 12 months. Differences in surgical protocol that were recorded include the use of gas, type and concentration of gas if used, and size of needle used for the surgery. Other factors collected include length of follow-up, gender, age of patient, history of smoking, history of diabetes, history of hypertension and indication of cataract surgery. Center Point Thickness was measured by Optical Coherence Tomography and visual acuity was measured by the Snellen chart. Clinical assessments were made by 8 retina doctors within a multi-center retina practice.
In total, 282/538 (52.4%) surgeries were eligible for inclusion, which excludes eyes needing re-operation for post-operative complications, eyes with other ocular diseases, or lack of follow-up, with an average follow-up of 9.21 months. 56/282 eyes (19.9%) did not receive cataract surgery pre-operatively, during the 12-month follow-up or up to the date at the time the last data collection was made. There was an average gain of 1.45 lines with an average pre-operation visual acuity of 20/62. 79/282 eyes (28%) gained >3 lines, 19/282 (6.7%) lost >3 lines and 263/282 (93.3%) maintained vision or lost <3 lines of vision. There was an average loss of 104 microns over the course of follow-up from the pre-operation average of 436 microns. 50/282 (17.7%) received gas (SF6, air, or C3F8) during surgery and gained an average of 2.52 lines with an average pre-operation visual acuity of 20/93. The remaining 232/282 (82.3%) did not receive gas with surgery and gained 1.22 lines with an average pre-operation visual acuity of 20/58. 18 patients that were tobacco users at the time of surgery required surgery on average 9 years earlier than non-tobacco users.
As opposed to visual acuity and retinal thickness pre-operation, ERM surgery seems to have an effective response in most patients and use of gas may have an added benefit. It was observed that pre-operation visual acuity and center point thickness have an effect on the final outcome. In addition, use of tobacco may cause an earlier need of an ERM but further study may be required.
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