Limited Vitrectomy versus Complete Vitrectomy for Epiretinal Membranes: A Comparative Multicenter Trial

Area of Science:

• Ophthalmology
• Surgical Innovation
• Retinal Surgery

Background:

• Epiretinal membrane (ERM) affects vision by distorting the macula.
• Vitrectomy is a common surgical procedure for ERM removal.
• The extent of vitreous removal (limited vs. complete) is a subject of ongoing surgical debate.

Purpose of the Study:

• To compare the efficacy of limited vitrectomy versus complete vitrectomy for ERM removal.
• To evaluate differences in surgical times between the two vitrectomy approaches.
• To assess and compare complication rates associated with limited and complete vitrectomy.

Main Methods:

• Retrospective analysis of 139 eyes with ERM undergoing vitrectomy in a multicentre European study (Jan 2017 - July 2018).
• Eyes were categorized into limited vitrectomy (posterior vitreous detachment induced to the equator) and complete vitrectomy (posterior vitreous detachment induced to the vitreous base).
• Comparison of iatrogenic retinal breaks, retinal detachment, surgical duration, and visual outcomes (BCVA, central macular thickness).

Main Results:

• Limited vitrectomy was performed in 47% of eyes and complete vitrectomy in 53%.
• No significant differences in iatrogenic retinal tears (5% vs. 7%) or retinal detachment (3% vs. 0%) were observed between groups.
• Both surgical approaches led to significant improvements in best-corrected visual acuity and central macular thickness, with no intergroup differences.
• Surgical time was significantly shorter for limited vitrectomy (91% < 1 hour) compared to complete vitrectomy (71% < 1 hour).

Conclusions:

• Limited vitrectomy is a time-efficient surgical technique for ERM removal.
• The efficacy and complication profile of limited vitrectomy are comparable to complete vitrectomy.
• Limited vitrectomy presents a viable alternative for ERM surgery, offering reduced operative time without compromising outcomes.