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Kyle Godfrey, Tanuj Banker, Eric Weichel, Retina Group of Washington Retinal Detachment Study Group; Epiretinal Membrane Peeling Following Uncomplicated Primary Retinal Detachment Repair. Invest. Ophthalmol. Vis. Sci. 2013;54(15):5799.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the incidence and outcome of epiretinal membrane (ERM) peeling with pars plana vitrectomy (PPV/MP) following uncomplicated small gauge PPV repair of primary rhegmatogenous retinal detachments (RD).
A consecutive interventional case series from 2002 to 2012 by one group of retina surgeons performing PPV/MP after uncomplicated primary RD repair using either 23 or 25 gauge PPV instrumentation with or without scleral buckle (SB). Exclusion criteria included preoperative proliferative vitreoretinopathy, pre-existing ERM, pre-existing macular disease, previous PPV or SB, and documented follow-up of less than 3 months. Primary outcome measures included: 1) rate of PPV/MP, and 2) pre/postoperative central macular thickness (CSMT) and central foveal thickness (CPT), as measured by optical coherence tomography (OCT). Secondary outcome measures included: 1) pre/postoperative visual outcomes, 2) rates of cystoid macular edema (CME) confirmed by OCT/fluorescein angiography, and 3) identifying risk factors associated with post-operative CME development.
204 eyes with post operative ERM and a mean age 60.0 years ± 17.6 years were identified following uncomplicated RD repair. The mean visual acuity was 20/40 (logMAR .32 ± .38). 32 eyes (15.7%) underwent PPV/MP. In this group, the mean preoperative visual acuity was 20/100 (logMAR .86 ± .65) improving to 20/50 (logMAR .43 ± .43) postoperatively (p<0.006). The mean preoperative CSMT was 397.5µ ± 127.3 improving to 282.6µ ± 73.3 postoperatively (p<0.0001). There were 9 (28.1%) cases of chronic postoperative CME. The mean time from RD repair to PPV/MP was 326.1 +/- 299.1 days. There was not a statistically significant difference in PPV/MP or CME rates with regards to lens status.
PPV/MP is common following uncomplicated RD repair. PPV/MP can significantly improve visual acuity and decrease CSMT. Eyes that have undergone PPV/MP require close follow-up to rule out chronic CME.
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