Flexible Rake for Removal of Epiretinal Membranes

Abstract

Abstract: : Purpose:Successful epiretinal membrane surgery is often limited by post operative cystoid macular edema and residual epiretinal tissue. The purpose of this study is to develop a novel surgical instrument that allows complete removal of epiretinal membrane tissue in an atraumatic fashion. Methods:A novel epiretinal membrane rake was developed. The rake is composed of multiple flexible tines that are extended from the instrument. Once completely extended the tines engage a large surface area of the ERM allowing complete removal without need for a defined membrane edge or incision in the ERM. A prospective case series of patients undergoing removal of epiretinal membrane during vitrectomy was conducted using the rake. Results:8 consecutive patients underwent vitrectomy with removal of epiretinal membrane using the membrane rake. Mean pre–operative ETDRS visual acuity was 20/80. 75 % of patients had cystoid macular edema noted on fluorescein angiography. 1 patient had an intraoperative retinal tear. 1 patient was noted to have intraoperative intraretinal hemorrhages following ERM removal. At average last follow up of 6 weeks average ETDRS visual acuity was 20/25. No patients had persistent ERM or CME. Conclusions:The epiretinal membrane rake appears to allow complete and atraumatic removal of epiretinal membrane tissue without significant risk. Early results suggest the rake is associated with good visual recovery and a very low rate of persistent ERM and CME.

Keywords: macula/fovea • vitreoretinal surgery