Purchase this article with an account.
Mauro Sartore, Barbara Parolini, Grazia Pertile; Incidence Of Surgically Induced Macular Edema Occurring After 23 Gauge Pars Plana Vitrectomy For Epiretinal Membrane. Invest. Ophthalmol. Vis. Sci. 2011;52(14):4503.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To evaluate the incidence of postoperative macular edema in a series of eyes operated for epiretinal membrane (ERM) with transconjuctival 23-gauge pars plana vitrectomy. To analyze the risk factors of post-vitrectomy macular edema and the effect of surgical induced macular edema (SIME) on visual function.
Single-center, retrospective, non-comparative, interventional case series. Retrospective review of the charts of 193 eyes, which underwent 23-gauge transconjunctival pars plana vitrectomy to treat ERM. Among them, 90 eyes of 89 patients underwent vitrectomy and combined phacoemulsification and IOL implantation (combined group) while 103 eyes of 102 patients received only vitrectomy (non combined group). Postoperative visits were performed at 1, 3, 6 and 12 months. Data were collected on best corrected visual acuity (BCVA) and central foveal thickness (CFT) measured at OCT. SIME was defined as postoperative CFT 50 microns higher than the preoperative CFT.
The incidence of SIME in the whole group of 193 eyes was 12.4%. SIME was experienced in 16 of 90 eyes (17.8%) of the combined group and only in 8 of 103 eyes (7.8%) of the non combined group. At 12 months BCVA was statistically reduced in the groups with edema respect to corresponding groups without edema (P=0.0001). Mean CFT was 420±85µm at baseline, increased to 500±94µm at the 3-months visit and remained stable both at the 6-months visit (469±111µm) and at the12-month visit (495±105µm).
SIME after vitrectomy is a severe complication in the surgical management of macular pucker. Treatment of SIME with NSAIDs and steroids achieved poor results in terms of increased BCVA and reduction of CFT. The combination with facoemulsification seems to increase the incidence of SIME but we cannot conclude that this could be a significant risk factor until other intraoperative factors will be studied, through prospective studies.
This PDF is available to Subscribers Only