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Epiretinal membrane removal in diabetic eyes: comparison of viscodissection with conventional methods of membrane
R A Grigorian1, A Castellarin, R Fegan
1The Institute of Ophthalmology and Visual Science, UMDNJ-New Jersey Medical School, NJ, USA.
Aims:
To compare conventional methods of epiretinal membrane peeling with viscodissection.
Methods:
154 eyes with proliferative diabetic retinopathy (PDR) that underwent pars plana vitrectomy with membrane dissection (89 traditional, 65 viscodissection) were studied retrospectively. Incidence of retinal breaks (RBs), length of time under anaesthesia, postoperative intraocular pressure, retinal reattachment rate, and final visual acuity (VA) were measured.
Results:
To compare cases of similar complexity, a "complexity score" was defined. The average complexity score for cases done with and without viscodissection was 4.7 and 3.2, respectively. The mean frequency of RBs in eyes undergoing viscodissection was 0.43 (SD 0.5) v 0.14 (0.35) RBs/eye without viscodissection. In complex cases, the frequency of posterior/peripheral RBs was 0.31 (0.47)/0.13 (0.34) RBs/eye, respectively, with viscodissection v 0.12 (0.33)/0.23 (0.43) RBs/eye without viscodissection. None of these differences were statistically significant. The average preoperative/postoperative VA (logMAR) in the viscodissection cohort was 1.7/1.3 (range 0.3 to >1.9/0.1 to >1.9) v 1.4/1 (range 0.48 to >1.9/0.1 to >1.9) in the non-viscodissection cohort, among eyes with 6 months of follow up. Anaesthesia duration was significantly shorter for cases done without viscodissection (p=0.03), but cases done with viscodissection were significantly more complex than cases done without viscodissection (p<0.0001).
Conclusion:
Viscodissection appears to be a safe and effective alternative technique in eyes with PDR. Owing to the retrospective nature of the study, additional studies are warranted.
Insights
Viscodissection is a safe and effective alternative for epiretinal membrane peeling in proliferative diabetic retinopathy (PDR). While not significantly reducing retinal breaks, it handles complex cases effectively, though anesthesia time was longer.
Area of Science:
- Ophthalmology
- Retinal Surgery
- Diabetic Retinopathy Treatment
Background:
- Epiretinal membrane (ERM) peeling is a common surgical procedure.
- Proliferative diabetic retinopathy (PDR) often necessitates complex membrane dissection.
- Traditional ERM peeling methods carry risks and challenges.
Purpose of the Study:
- To compare the efficacy and safety of conventional epiretinal membrane peeling with viscodissection.
- To evaluate outcomes in eyes with proliferative diabetic retinopathy (PDR).
Main Methods:
- Retrospective study of 154 eyes with PDR undergoing pars plana vitrectomy.
- Comparison between 89 eyes with traditional membrane dissection and 65 eyes with viscodissection.
- Analysis of retinal breaks, anesthesia duration, intraocular pressure, reattachment rates, and visual acuity.
Main Results:
- Viscodissection cases were significantly more complex (complexity score 4.7 vs 3.2).
- No statistically significant differences in the incidence of retinal breaks between the two groups.
- Anesthesia duration was significantly shorter for traditional methods (p=0.03).
Conclusions:
- Viscodissection is a safe and effective alternative technique for ERM peeling in PDR.
- Further studies are warranted due to the retrospective nature of this research.
- Viscodissection may be particularly useful in managing complex PDR cases.
