Abstract
Purpose: :
To describe safety and utility of 23G vitrectomy using amber filter in patients with epiretinal membrane and to compare morfological and functional outcomes with the standard vitrectomy.
Methods: :
A prospective case series of 10 eyes of 10 patients underwent to vitrectomy for epiretinal membrane (ERM) peeling using xenon light with amber filter (n° 5 patients, group A) and without filter (n° 5 patients, group B). Best corrected visual acuity (BCVA), spectral domain optical coherence tomography (OCT) retinal thickness, autofluorescence (AF) and microperimetry were recorded at the diagnosis,one week after surgery and then monthly after surgery.Results were compared between the two groups.
Results: :
The mean (range) age of patients was 64,4 (50-87) years with 6 (60%) males and 7 (70%) right eyes. All patients presented at the diagnosis an ERM with retinal traction with a mean (range) central retinal thickness (CRT) of 431,2μm (288-490) in group A and 405μm(279-659) in group B before surgery; after surgery CRT was in mean (range) 346,4μm (265-408) in group A and 379,4μm (276-525) in group B. BCVA improved in both groups more than 2 lines. Any retinal pigment epithelium (RPE) changes at AF or at OCT scan were detected in both groups even if in licterature EPR mottling was seen after one week only from surgery in patients with conventional vitrectomy. Microperimetry showed an improvement in sensitivity without any differences in each groups.
Conclusions: :
All patients showed an improvement in the BCVA and in the CRT (-84,8μm in group A and -25,6μm in group B). Both ERM and internal limiting membrane (ILM) were well seen during surgery without any differences between each groups.Amber filter wavelenght is between 550-650μm; on the other hand all other conventional filters wavelenght are between 400-650μ. As known from literature removal light beteewn 400μm and 500μm is probably more helpful in protecting the retina. Certainly Amber filter (192,624 L/HzW 10L=19 hr 49min 9s) is 118% safer than Xenon 435nm and safer than Yellow and Green Tint filter too. Concluding, vitrectomy using amber filter should be considered for all surgery procedures as useful and safer than other filters.
Keywords: vitreoretinal surgery • macula/fovea • imaging/image analysis: clinical