title: Clinical outcomes of double membrane peeling with or without simultaneous phacoemulsification/gas tamponade for vitreoretinal-interface-associated (VRI) disorders.
abstract: The purpose of this study is to evaluate the clinical outcomes of double membrane (ERM & ILM) peeling and the effect of combined cataract surgery and SF6 gas injection in vitreoretinal interface (VRI) disorders. This is a retrospective interventional study. Seventy-two eyes with idiopathic vitreoretinal interface abnormalities that underwent 23 gauge pars plana vitrectomy with "double stain and double peel" technique were reviewed. SD-OCT was used to classify VRI disorders into following 4 groups: 44 in ERM type, 17 in VMTS type, 7 in macular pseudohole (MPH) type, and 4 in lamellar macular hole (LMH) type. ERM was a common association in all types. Mean preoperative BCVA improved from 0.58 ± 0.14 logMAR to 0.27 ± 0.16 logMAR units (p = 0.001). Mean CFT reduced from 409.17 ± 122.31 µm preoperatively to 277.28 ± 0.16 µm postoperatively (p < 0.0001). Among the VRI subtypes, visual improvement was significant except in LMH variety (ERM type, p = 0.0029; VMTS type, p = 0.0281; MPH type, p = 0.05; and LMH type, p = 0.7926). Mean change in CFT from baseline was least in LMH cases (p = 0.0093). There was no significant difference in BCVA and CFT in the group who had combined phacovitrectomy versus pseudophakic group (p > 0.05). Use of intraocular SF6 gas tamponade did not show any added benefits among the groups (p > 0.05). Improvement in foveal contour was seen in all groups. Simultaneous removal of ILM along with ERM during surgery for VRI disorders helps in restoring normal foveal contour with a favorable visual outcome. Combined cataract extraction or use of intraocular SF6 gas injection does not affect the surgical results.
authors.affiliation: Dr. Agarwal's Retina Foundation and Dr. Agarwal's Eye Hospital, 19, Cathedral Road, Chennai, 600086, India. kshitiz_k@rediffmail.com.
authors.forename: Kshitiz
authors.initials: K
authors.lastname: Kumar
authors.affiliation: Dr. Agarwal's Retina Foundation and Dr. Agarwal's Eye Hospital, 19, Cathedral Road, Chennai, 600086, India.
authors.forename: Nisha
authors.initials: N
authors.lastname: Chandnani
authors.affiliation: Dr. Agarwal's Retina Foundation and Dr. Agarwal's Eye Hospital, 19, Cathedral Road, Chennai, 600086, India.
authors.forename: Pallavi
authors.initials: P
authors.lastname: Raj
authors.affiliation: Dr. Agarwal's Retina Foundation and Dr. Agarwal's Eye Hospital, 19, Cathedral Road, Chennai, 600086, India.
authors.forename: Amar
authors.initials: A
authors.lastname: Agarwal
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001485:Basement Membrane / Q000473:pathology / Q000601:surgery*; D058450:Endotamponade; D019773:Epiretinal Membrane / Q000473:pathology / Q000601:surgery*; D005128:Eye Diseases / Q000175:diagnosis / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification; D012164:Retinal Diseases / Q000175:diagnosis / Q000601:surgery*; D012189:Retrospective Studies; D013459:Sulfur Hexafluoride / Q000008:administration & dosage*; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy; D014822:Vitreous Body / Q000473:pathology / Q000601:surgery*
chemical_list: D013459:Sulfur Hexafluoride
keywords: Double membrane peeling; Epiretinal membrane; Lamellar macular hole; Macular pseudohole; Vitreomacular traction syndrome; Vitreoretinal interface