Impact of Intraoperative OCT-Assisted Epiretinal Membrane Peeling on ERM Recurrence Rate

Abstract

Purpose : To assess the impact of intraoperative optical coherence tomography (iOCT) use on recurrence of epiretinal membranes (ERM) in patients who underwent pars plana vitrectomy and epiretinal membrane peeling compared to standard surgical visualization techniques.

Methods : This is a retrospective case-control study. We included all consecutive patients who underwent pars plana vitrectomy for idiopathic epiretinal membrane removal at the University of California, Davis Eye Center between 2014 and 2017 to evaluate surgical outcomes in the 18 months before and after routine use of a commercial iOCT device. Patients with less than 3 months of follow up were excluded from the study. We evaluated clinical data including age, sex, visual acuity, central macular thickness, and ERM recurrence up to 3-months after surgery; as well as surgical parameters including duration of surgery, use of vital dyes, peeling of internal limiting membrane (ILM), and use of iOCT. Multivariate logistic regression was used to determine the factors associated with ERM recurrence.

Results : A total of 93 patients were included in the study. Mean age was 69.5 ± 8.75, and most were male (56, 60.2%). iOCT was employed in 50 patients (53.8%). There was no statistical difference in duration of surgery before (63.2 ± 22.4 minutes) and after (71.1 ± 28.9 minutes) after iOCT implementation (P=0.25). ERM recurrence was more commonly seen on post-operative OCT in pre-iOCT group (5, 12.5%) than in post-iOCT group (2, 4%), although this difference was not statistically significant (P=0.13). The only factor that was associated with the decreased rate of recurrence was the use of triamcinolone at the time of surgery to stain the epiretinal membrane (p=0.02).

Conclusions : Routine use of a commercial intraoperative OCT system during ERM peeling surgery did not impact surgical time, but showed a trend toward lower ERM recurrence rate compared to standard surgical visualization techniques.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.