title: LONG-TERM RETROSPECTIVE ANALYSIS OF VISUAL ACUITY AND OPTICAL COHERENCE TOPOGRAPHIC CHANGES AFTER SINGLE VERSUS DOUBLE PEELING DURING VITRECTOMY FOR MACULAR EPIRETINAL MEMBRANES.
abstract: OBJECTIVE
  To determine the long-term effect of internal limiting membrane with associated epiretinal membrane (ERM) peeling versus single peeling alone in terms of best-corrected visual acuity and anatomical outcomes on spectral-domain optical coherence tomography.
  
  
  METHODS
  This retrospective comparative cohort study of patients who had follow-up of >1 year and underwent surgery for ERM by a single surgeon (S.C.) from January 1, 2008 to December 31, 2012 compared cases in which the internal limiting membrane was stained with brilliant blue G to facilitate double peeling (n = 42) and single peeling (n = 43) of the ERM alone for up to 3 years of follow-up. For continuous variables, an independent two-tailed t-test was performed. For binary variables, the Fisher's exact test was performed. Statistical significance was defined as P < 0.05.
  
  
  RESULTS
  Eighty-five of 142 patients fit the inclusion criteria. At the last follow-up, the single-peeling group were more likely to have ERM remaining in the central fovea postoperatively (P = 0.0020, becoming significant by postoperative Year 1, P = 0.022) and less likely to develop inner retinal dimpling (P = 0.000, becoming significant by postoperative Month 3, P = 0.015). At 3 years, central foveal thickness had decreased in the single-peeling group by -136.9 µm and by -84.1 μm in the double-peeling group, which was not significantly different (P = 0.08). Mean best-corrected visual acuity improved in both the groups at all time points. There was no statistically significant difference between the 2 groups at 3 years (P = 0.44; single-peeling group, 0.32 ± 0.42, Snellen 20/42; double-peeling group, 0.23 ± 0.27, Snellen 20/34).
  
  
  CONCLUSIONS
  Brilliant blue G-assisted internal limiting membrane peeling for ERM results in a more thorough removal of residual ERM around the paracentral fovea. However, there is no difference in long-term best-corrected visual acuity at 3 years and a greater likelihood of inner retinal dimpling.
authors.affiliation: *Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University College of Physicians and Surgeons, New York, New York; †East Bay Retina Consultants, Inc, Oakland, California; ‡Vitreous Retina Macula Consultants of New York, New York, New York; and §LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear and Throat Hospital, New York, New York.
authors.forename: Jesse J
authors.initials: JJ
authors.lastname: Jung
authors.forename: Quan V
authors.initials: QV
authors.lastname: Hoang
authors.forename: Megan L
authors.initials: ML
authors.lastname: Ridley-Lane
authors.forename: Dov B
authors.initials: DB
authors.lastname: Sebrow
authors.forename: Elona
authors.initials: E
authors.lastname: Dhrami-Gavazi
authors.forename: Stanley
authors.initials: S
authors.lastname: Chang
mesh_terms: D000368:Aged; D001485:Basement Membrane / Q000502:physiology / Q000601:surgery; D004396:Coloring Agents / Q000008:administration & dosage; D019773:Epiretinal Membrane / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019654:Lens Implantation, Intraocular; D008297:Male; D018918:Phacoemulsification; D019591:Pseudophakia / Q000503:physiopathology; D012189:Retrospective Studies; D012394:Rosaniline Dyes / Q000008:administration & dosage; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology*; D014821:Vitrectomy / Q000379:methods
chemical_list: D004396:Coloring Agents; D012394:Rosaniline Dyes; C004692:coomassie Brilliant Blue