Skip to main content

Advertisement

Log in

Early postoperative changes of the foveal surface in epiretinal membranes: comparison of 23-gauge macular surgery with air vs. balanced salt solution

  • Retinal Disorders
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Objective

To analyze the foveal surface using binary image analysis after spectral-domain optical coherence tomography (SD-OCT) following 23-gauge macular surgery in epiretinal membranes (ERM) using either air tamponade (AIR) or balanced salt solution (BSS).

Methods

One hundred twenty-four eyes (124 patients) with ERM that had undergone membrane peeling with installation of air or BSS were analyzed retrospectively. Ophthalmic examination was performed at baseline and 3 months. Outcome measures: The foveal area and surface symmetry, area matched thickness, area matched contour, and best-corrected visual acuity (BCVA). The OCT images were analyzed after binary conversion with ImageJ software.

Results

Eighty eyes (80 patients) of 124 screened patients were included (AIR group: 39 patients, BSS group: 41 patients). Median follow-up time was 14 weeks (range, 9–19 weeks). Three months after surgery, the median horizontal area decreased significantly in both groups (p < 0.0001). At follow-up, the foveal surface symmetry values for the BSS group (median, 22.73 μm, range, 0–153) were significantly lower than for the AIR group (median, 23.95 μm, range, 0–160.43) (p < 0.0001). The area-matched thickness increased significantly in both groups (p < 0.001). The AIR group showed a significant increase of the area matched contour for the nasal located measurement-areas N1 (p < 0.0003), N2 (p < 0.0079), N3 (p < 0.007). The BSS group showed a significant increase of the area-matched contour for the measurement areas N1 (p < 0.019), N2 (p < 0.0014), and N4 (p < 0.022). After surgery, median BCVA for both groups increased significantly to 0.3 logMAR.

Conclusions

The analysis of early contour changes after ERM surgery was technically possible. Long-term data have to be looked at before the clinical impact of this methodology can be estimated. Although there were no big differences between both groups (AIR vs. BSS), this could change within a longer and more representative follow-up.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Ting FS, Kwok AK (2005) Treatment of epiretinal membrane: an update. Hong Kong Med J 11:496–502

    Google Scholar 

  2. Lim JW, An TS (2011) Results at 12 months after surgery for epiretinal membrane: the foveal configurations by optical coherence tomography. Acta Ophthalmol (Copenh) 89:e661–662

    Article  Google Scholar 

  3. Wong JG, Sachdev N, Beaumont PE, Chang AA (2005) Visual outcomes following vitrectomy and peeling of epiretinal membrane. Clinical Experimental Ophthalmology 33:373–378

    Article  PubMed  Google Scholar 

  4. Thompson JT (2011) Advantages and limitations of small gauge vitrectomy. Survey Ophthalmology 56:162–172

    Article  Google Scholar 

  5. Eckardt C (2005) Transconjunctival sutureless 23-gauge vitrectomy. Retina 25:208–211

    Article  PubMed  Google Scholar 

  6. Clark A, Balducci N, Pichi F, Veronese C, Morara M, Torrazza C, Ciardella AP (2012) Swelling of the arcuate nerve fiber layer after internal limiting membrane peeling. Retina 32:1608–1613

    Article  PubMed  Google Scholar 

  7. Sigler EJ, Randolph JC, Charles S (2013) Delayed onset inner nuclear layer cystic changes following internal limiting membrane removal for epimacular membrane. Graefes Arch Clin Exp Ophthalmol 251:1679–1685

    Google Scholar 

  8. Inoue M, Arakawa A, Yamane S, Kadonosono K (2012) Long-term outcome of preoperative disrupted inner/outer segment junctions assessed using spectral-domain optical coherence tomography in patients with idiopathic epiretinal membrane. Ophthalmologica 228:222–228

    Google Scholar 

  9. Krebs I, Smretschnig E, Moussa S, Brannath W, Womastek I, Binder S (2011) Quality and reproducibility of retinal thickness measurements in two spectral-domain optical coherence tomography machines. Investigative Ophthalmology Visual Sci 52:6925–6933

    Article  Google Scholar 

  10. Rasband WS (1997–2012) Image J

  11. Treumer F, Wacker N, Junge O, Hedderich J, Roider J, Hillenkamp J (2011) Foveal structure and thickness of retinal layers long-term after surgical peeling of idiopathic epiretinal membrane. Investigative Ophthalmology Visual Sci 52:744–750

    Article  Google Scholar 

  12. Niwa T, Terasaki H, Kondo M, Piao CH, Suzuki T, Miyake Y (2003) Function and morphology of macula before and after removal of idiopathic epiretinal membrane. Investigative Ophthalmology Visual Sci 44:1652–1656

    Article  Google Scholar 

  13. Suh MH, Seo JM, Park KH, Yu HG (2009) Associations between macular findings by optical coherence tomography and visual outcomes after epiretinal membrane removal. Am J Ophthalmol 147(473–480):e473

    Article  Google Scholar 

  14. Ivanovska-Adjievska B, Boskurt S, Semiz F, Yuzer H, Dimovska-Jordanova V (2012) Treatment of idiopathic macular hole with silicone oil tamponade. Clin Ophthalmol 6:1449–1454

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  15. Cekic O, Cakir M, Alagoz N, Yilmaz OF (2011) Retinal thickness change in relation to visual acuity improvement after 23-gauge vitrectomy for idiopathic epimacular membrane. Eye 25:180–184

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  16. Massin P, Allouch C, Haouchine B, Metge F, Paques M, Tangui L, Erginay A, Gaudric A (2000) Optical coherence tomography of idiopathic macular epiretinal membranes before and after surgery. Am J Ophthalmol 130:732–739

    Article  CAS  PubMed  Google Scholar 

  17. Almony A, Nudleman E, Shah GK, Blinder KJ, Eliott DB, Mittra RA, Tewari A (2012) Techniques, rationale, and outcomes of internal limiting membrane peeling. Retina 32:877–891

    Article  PubMed  Google Scholar 

  18. Pesin SR, Olk RJ, Grand MG, Boniuk I, Arribas NP, Thomas MA, Williams DF, Burgess D (1991) Vitrectomy for premacular fibroplasia. Prognostic factors, long-term follow-up, and time course of visual improvement. Ophthalmology 98:1109–1114

    Article  CAS  PubMed  Google Scholar 

  19. Rice TA, De Bustros S, Michels RG, Thompson JT, Debanne SM, Rowland DY (1986) Prognostic factors in vitrectomy for epiretinal membranes of the macula. Ophthalmology 93:602–610

    Article  CAS  PubMed  Google Scholar 

  20. Itoh Y, Inoue M, Rii T, Hiraoka T, Hirakata A (2012) Correlation between length of foveal cone outer segment tips line defect and visual acuity after macular hole closure. Ophthalmology 119:1438–1446

    Article  PubMed  Google Scholar 

  21. Chhablani JK, Kim JS, Cheng L, Kozak I, Freeman W (2012) External limiting membrane as a predictor of visual improvement in diabetic macular edema after pars plana vitrectomy. Graefes Arch Clin Exp Ophthalmol 250:1415–1420

    Google Scholar 

Download references

Conflict of interest

All authors disclose no actual or potential conflicts of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Martin A. Leitritz.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Leitritz, M.A., Ziemssen, F., Voykov, B. et al. Early postoperative changes of the foveal surface in epiretinal membranes: comparison of 23-gauge macular surgery with air vs. balanced salt solution. Graefes Arch Clin Exp Ophthalmol 252, 1213–1219 (2014). https://doi.org/10.1007/s00417-014-2573-y

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00417-014-2573-y

Keywords

Navigation