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Tomoki Kurihara, Kazuhiro Watanabe, Hideki Sonobe, Toshihide Kurihara, Norihiro Nagai, Hajime Shinoda, Kazuo Tsubota, Yoko Ozawa; Internal limiting membrane peeling may cause post-operative visual field defects in epiretinal membrane patients. Invest. Ophthalmol. Vis. Sci. 2019;60(9):5780.
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To determine the influence of internal limiting membrane (ILM) peeling during pars plana vitrectomy (PPV) on post-operative visual field defects in epiretinal membrane (ERM) patients.
This study was a retrospective chart review which examined 42 ERM patients (67.0±8.5 years old, 14 male) who underwent PPV with or without ILM peeling at Keio University Hospital between January 2014 and December 2017. Patients who had pre-operative visual field defects were excluded. General eye examinations and Humphrey 30-2 SITA standard visual field testing were performed pre-operatively and 1 month after surgery. Post-operative ILM status was verified using Brilliant Blue G (BBG) staining during PPV (approved by the Ethics Committee of Keio University School of Medicine; approval number, 20110115). The data of the patients with or without ILM peeling were compared using IBM SPSS Statistics version 25.0. The study adhered to the tenets of the Declaration of Helsinki, and was registered as UMIN000007649. Informed consent was obtained from all subjects.
Twenty-six eyes (61.9%) underwent PPV with ILM peeling and sixteen eyes (38.1%) without ILM peeling. Cataract surgery was combined with PPV for 19 eyes in the ILM-peeling group and 14 eyes in the ILM-sparing group (73.1% vs. 87.5%, p = 0.269). Between the two groups, there were no statistically significant differences in age, axial length, pre-operative and post-operative best-corrected visual acuity, and intraocular pressure, as well as mean deviation and pattern standard deviation values. One month post-operatively, however, the incidence of visual field defects as defined by the Anderson-Patella criteria was significantly greater in the ILM-peeling group compared with the ILM-sparing group (73.1% vs. 6.3%, p < 0.0001).
The findings in this study suggest that ILM peeling during PPV may be a risk factor for the development of post-operative visual field defects. Thus, caution is warranted when considering ILM peeling for the surgical treatment of ERM patients, although further studies are required to confirm these findings.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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