Abstract
Purpose :
To evaluate the ganglion cell layer(GCL)-inner plexiform layer(IPL) thickness after internal limiting membrane(ILM) peeling with or without intravitreal gas injection(IVGI) or surgical induction of posterior vitreous detachment(PVD).
Methods :
80 patients, who were diagnosed with epiretinal membrane(ERM) or macular hole and received surgical intervention, were retrospectively reviewed. 40 patients were treated with ILM peeling and 40 patients were treated with epiretinal membrane(ERM) removal, but not with ILM peeling. The patients were categorized depending on ILM peeling, IVGI, and surgical induction of PVD. The GCL-IPL thickness was measured with the optical coherence tomography. The average and the sectorial thickness of GCL-IPL were compared.
Results :
The GCL-IPL thickness in ILM peeling group significantly decreased(-13.80±22.63µm; p<0.001) and in ERM removal without ILM peeling group was not significantly different compared with preoperative GCL-IPL thickness(+1.21±22.53µm; p=0.546). The difference showed statistically significant between two groups(p=0.038). In ILM peeling group, GCL-IPL thicknesses were not significantly different in IVGI group(-17.41±23.92µm vs. -7.25±19.05µm; p=0.109) and were significantly decreased in surgical induction of PVD group(-23.06±23.92µm vs. -7.25±19.05µm; p=0.020). In sectorial analysis, reduction of the temporal GCL-IPL thickness was the largest and significantly different compared with the nasal GCL-IPL thickness in ILM peeling group(-19.73±28.55µm vs. -7.42±19.90µm; p=0.005). In ILM peeling with PVD induction group, reduction of the nasal GCL-IPL thickness was greater than ILM peeling without PVD induction group(-17.03±22.01µm vs. -1.02±15.71µm).
Conclusions :
The ILM peeling and surgical induction of PVD may damage ganglion cells. Therefore, gentle ILM peeling and surgical induction of PVD may be needed to minimize ganglion cell damage, especially when ILM peeling was performed and in glaucomatous patients.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.