Biomaterial Database

Epiretinal Membrane Surgery after Retinal Detachment Repair: Visual Acuity Outcomes and OCT Analysis. 2022

Rebecca Russ Soares, and Raziyeh Mahmoudzadeh, and Mirataollah Salabati, and Erik Massenzio, and Rachel Israilevich, and Samir N Patel, and John Hinkle, and Ajay E Kuriyan, and Jason Hsu, and Sunir J Garg, and M Ali Khan

Wills Eye Hospital, Mid Atlantic Retina, Thomas Jefferson University, Philadelphia, Pennsylvania.

To assess visual acuity (VA) outcomes of epiretinal membrane (ERM) surgery following primary rhegmatogenous retinal detachment (RD) repair and to identify OCT features predictive of visual outcomes. Retrospective, consecutive case series. Eyes undergoing pars plana vitrectomy (PPV) with membrane peel (MP) surgery for ERM following primary RD repair (PPV with or without scleral buckle (SB) and gas tamponade). Retrospective chart review from 2015 to 2018. A previously described ERM grading scale was utilized for OCT structural analysis. Visual acuity (VA) and change in VA from pre- MP to 6 months and final follow-up. Secondary outcomes included RD and OCT features predictive of VA, as well as RD factors associated with need for subsequent MP surgery. 53 eyes of 53 patients underwent MP following RD repair. VA improved significantly from logMAR 1.00 ± 0.51 (Snellen 20/200) pre-MP to 0.45 ± 0.41 (20/56) at 6 months and 0.42 ± 0.41 (20/53) at final follow-up, (p<0.001) for each respectively. Macula on eyes had better 6 month [0.29 ± 0.18 (20/39) vs. 0.51 ± 0.46 (20/65), p=0.02] and final VA [0.29 ± 0.14 (20/39) vs. 0.46 ± 0.47 (20/58), p=0.04] after MP surgery. VA improved significantly from pre-MP to 6 months and final follow-up regardless of macula status. MP occurring ≤180 days from RD repair and IS/OS loss were associated with worse pre-MP VA [1.13 ± 0.09 (20/270) vs. 0.82 ± 0.07(20/132), p=0.01 and 1.21 ± 0.07 (20/324) vs. 0.74 ± 0.09 (20/110) p=0.0003, respectively]. IS/OS loss [adjusted means 0.54 ± 0.07 (20/69) vs. 0.25 ± 0.08 (20/36) at final visit, p=0.006] and RD repair with PPV/SB [0.53 ± 0.08 (20/68) vs. 0.31 ±0.07 (20/41) at final visit, p=0.03] were significantly associated with worse VA at both 6 months and final follow-up. Eyes undergoing MP after RD repair have significant visual acuity gains independent of macula-status at time of RD repair. Pre-operative IS/OS disruption was the OCT feature best predictive of visual acuity.

UI	MeSH Term	Description	Entries
D008297	Male		Males
D008875	Middle Aged	An adult aged 45 - 64 years.	Middle Age
D011183	Postoperative Complications	Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery.	Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D012086	Reoperation	A repeat operation for the same condition in the same patient due to disease progression or recurrence, or as followup to failed previous surgery.	Revision, Joint,Revision, Surgical,Surgery, Repeat,Surgical Revision,Repeat Surgery,Revision Surgery,Joint Revision,Revision Surgeries,Surgery, Revision
D012160	Retina	The ten-layered nervous tissue membrane of the eye. It is continuous with the OPTIC NERVE and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the CHOROID and the inner surface with the VITREOUS BODY. The outer-most layer is pigmented, whereas the inner nine layers are transparent.	Ora Serrata
D012163	Retinal Detachment	Separation of the inner layers of the retina (neural retina) from the pigment epithelium. Retinal detachment occurs more commonly in men than in women, in eyes with degenerative myopia, in aging and in aphakia. It may occur after an uncomplicated cataract extraction, but it is seen more often if vitreous humor has been lost during surgery. (Dorland, 27th ed; Newell, Ophthalmology: Principles and Concepts, 7th ed, p310-12).	Retinal Pigment Epithelial Detachment,Detachment, Retinal,Detachments, Retinal,Retinal Detachments
D005260	Female		Females
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012189	Retrospective Studies	Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.	Retrospective Study,Studies, Retrospective,Study, Retrospective
D012591	Scleral Buckling	An operation for retinal detachment which reduces the size of the globe by indenting the sclera so that it approximates the retina.	Buckling, Scleral,Bucklings, Scleral,Scleral Bucklings