Abstract
Purpose :
To compare changes in the thickness of individual retinal layers, as assessed by automated segmentation, and changes in visual outcomes in patients undergoing epiretinal membrane (ERM) surgery with or without internal limiting membrane (ILM) peeling.
Methods :
Seventy six eyes of 76 patients who underwent pars plana vitrectomy by two surgeons for idiopathic ERM from January 2013 to March 2015 were retrospectively reviewed. During the vitrectomy, one surgeon removed the ERM with ILM peeling (Group 1: 39 patients), whereas the other surgeon performed epiretinal membranectomy without ILM peeling (Group 2: 37 patients). Automated segmentation was performed preoperatively and at 6 months postoperatively using optical coherence tomography (OCT) images obtained by Spectral Domain OCT (SD-OCT; Spectralis®; Heidelberg Engineering, Heidelberg, Germany).
Results :
Whereas a significant reduction in retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), and inner plexiform layer (IPL) thicknesses were noted in Group 1 at 6 months postoperatively, significant decreases in the RNFL, GCL, IPL, inner nuclear layer (INL), and outer plexiform layer (OPL) were observed in Group 2. The mean postoperative BCVA was better in Group 1 than in Group 2 at 6-month follow-up (Group 1: 0.11±0.02; Group 2: 0.20±0.04; p=0.020). At 6 months postoperatively, Group 1 manifested a greater mean postoperative GCL thickness (Group 1: 35.56±1.53 µm; Group 2: 29.86±2.16 µm; p=0.033) and less loss of GCL thickness (Group 1: -10.26±1.91 µm; Group 2: -19.86±2.74 µm; p=0.004), compared to Group 2.
Conclusions :
This study demonstrates that ILM peeling for ERM surgery produces better preservation of GCL and better postoperative BCVA compared to no ILM peeling.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.