title: Analysis of Choroidal Thickness Change after 25-Gauge Vitrectomy for Idiopathic Epiretinal Membrane with or without Phacoemulsification and Intraocular Lens Implantation.
abstract: OBJECTIVE
  This study aimed to evaluate choroidal thickness modifications before and after vitrectomy with or without phacoemulsification for idiopathic epiretinal membrane in the operated eye and in the unaffected fellow eye.
  
  
  METHODS
  In total, 53 eyes of 53 patients underwent 25-gauge pars plana vitrectomy plus internal limiting membrane peeling and air tamponade. Twenty-seven eyes underwent combined surgery with phacoemulsification and intraocular lens implantation. Choroidal thickness was measured using enhanced deep image spectral-domain optical coherence tomography at the fovea and at 500 and 2,500 µm from the fovea. Fellow eyes without any previous ocular surgery history served as controls.
  
  
  RESULTS
  Baseline comparison did not show significant differences between study and fellow eyes (p > 0.05). Choroidal thickness significantly decreased in the subfoveal area (p = 0.004) as well as at 500 µm (p = 0.026) and 2,500 µm nasally (p = 0.019) and at 500 µm (p = 0.039) and 2,500 µm (p = 0.005) temporally to the fovea. No significant changes were observed postoperatively in the superior and inferior areas (p > 0.05). No differences were found between eyes which underwent combined surgery and those which underwent vitrectomy alone (p > 0.05). The unaffected eyes did not show any significant changes (p > 0.05).
  
  
  CONCLUSIONS
  Comparison of baseline values did not show any differences between affected and unaffected eyes, meaning that choroidal thickness was not influenced by the development of epiretinal membrane. Vitrectomy plus epiretinal and inner limiting membrane removal may influence choroidal homeostasis, leading to a decrease in choroidal thickness in the subfoveal, nasal, and temporal areas. Combined surgery did not show significant differences when compared to vitrectomy alone.
authors.affiliation: Ophthalmology Unit, Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Pisa, Italy.
authors.forename: Giamberto
authors.initials: G
authors.lastname: Casini
authors.forename: Pasquale
authors.initials: P
authors.lastname: Loiudice
authors.forename: Stefano
authors.initials: S
authors.lastname: Lazzeri
authors.forename: Marco
authors.initials: M
authors.lastname: Pellegrini
authors.forename: Guido
authors.initials: G
authors.lastname: Ripandelli
authors.forename: Michele
authors.initials: M
authors.lastname: Figus
authors.forename: Flavio
authors.initials: F
authors.lastname: Dalle Lucche
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Cirmi
authors.forename: Marco
authors.initials: M
authors.lastname: Nardi
mesh_terms: D000368:Aged; D002386:Cataract / Q000150:complications*; D002829:Choroid / Q000000981:diagnostic imaging*; D019773:Epiretinal Membrane / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification / Q000379:methods*; D011446:Prospective Studies; D041623:Tomography, Optical Coherence / Q000379:methods*; D016896:Treatment Outcome; D014792:Visual Acuity; D014821:Vitrectomy / Q000379:methods*