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Impact of surgical case order on epiretinal membrane peeling surgery

Rayan A Alshareef1, Andrei Dan2, Zoya Chaudhry3

  • 1Department of Ophthalmology, King Abdulaziz University, Jeddah, Saudi Arabia.

Canadian Journal of Ophthalmology. Journal Canadien D'Ophtalmologie
|July 31, 2019
PubMed
Abstract

Insights

Surgical warm-up before epiretinal membrane (ERM) peeling does not impact complication rates or visual outcomes. Pre-operative vision remains the strongest predictor of post-operative results in ERM surgery.

Area of Science:

  • Ophthalmology
  • Surgical Outcomes
  • Retinal Surgery

Background:

  • Epiretinal membrane (ERM) peeling is a common surgical procedure.
  • The potential impact of a "surgical warm-up" on operative outcomes is not well-established.
  • Optimizing surgical performance and patient safety is a priority in retinal surgery.

Purpose of the Study:

  • To investigate whether a surgical warm-up period influences complication rates and surgical case times for epiretinal membrane (ERM) peeling.
  • To assess the effect of the first surgery of the day (warm-up) versus the second surgery (post-warm-up) on patient outcomes.

Main Methods:

  • A retrospective case-control study involving 108 patients undergoing ERM peeling by a single surgeon.
  • Comparison of complication rates, best-corrected visual acuity (BCVA) at 2 and 6 months, and surgical times between "warm-up" (first case) and "post-warm-up" (second case) surgeries.
  • Statistical analysis included chi-squared, t-tests, Fischer's exact test, and regression models.

Main Results:

  • No significant differences in postoperative BCVA at 2 and 6 months between warm-up and post-warm-up groups.
  • ERM peeling complication rates were similar between the two groups.
  • A trend towards more complex surgeries (requiring phacoemulsification) in the post-warm-up group was observed (13% vs 2%, p=0.03).

Conclusions:

  • Surgical warm-up does not appear to affect postoperative complication rates or visual acuity after ERM peeling.
  • Pre-operative visual acuity is the most significant predictor of postoperative BCVA.
  • The findings suggest that the order of cases in a surgical day does not critically impact ERM peeling outcomes.

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