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Focke Ziemssen, Martin Leitritz, Dita Zobor, Karl-Ulrich Bartz-Schmidt, Faik Gelisken; Early Morphologic Effects in SD-OCT after Epiretinal Membrane Peeling using either Air Tamponade or Balanced Salt Solution. Invest. Ophthalmol. Vis. Sci. 2011;52(14):4491.
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© ARVO (1962-2015); The Authors (2016-present)
To compare the early morphological changes in the fovea after macular surgery for epiretinal membranes (ERM) in transconjunktival 23G surgery using air or balanced salt solution (BSS) by spectral domain optical coherence tomography (SD-OCT).
Consecutive patients (30 eyes) with ERM were included in the retrospective analysis after receiving BSS or air tamponade at the end of surgery. Ophthalmic examination included best corrected visual acuity (BVCA) and SD-OCT. The OCT was performed preoperative and one month postoperatively. The central retinal thickness (CRT), the integrity of the inner/outer segments transition, foveal depression, subretinal and intraretinal fluid was evaluated in a masked fashion. Intraocular pressure (IOP) was compared between both groups. The group differences were detected by using Wilcoxon Signed-Rank test (α=0.05).
Mean age of the patients (14 male, 16 female) was 69 years (range:54-81 years). 15 of the eyes had air (group 1) and the remaining 15 patients (group 2) BSS in the vitreous cavity at the end of the surgery. While the 15 patients receiving air tamponade showed a tendency of a higher decrease in central retinal thickness (95%-CI: -90µm, -238µm) than the 15 patients without the 15 patients without tamponade (95%-CI: .61µm, -132µm), we found no effect of the endotamponade on the integrity of the ELM. One month after surgery, a significantly higher amount of foveal depression was reconstituted by the use of air tamponade (p<0.05). Slightly higher IOP values were measured during the first postoperative day with air (95%-CI: 8-14 mmHg) compared to BSS (95%-CI: 10-15 mmHg). Median BCVA increase of one line was seen in both groups at the 4 weeks examination. BCVA did not significantly differ between both groups.
Clearly marked morphologic effects were seen at an early time point after ERM peeling, independent of the use of air tamponade. The limited data of this pilot study does only allow careful comparative statements about the treatment efficacy and retinal thickening. However, further follow-ups might show effects on cataract formation and recurrence/persistence of the retinal sublayers.
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