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Intraoperative Optical Coherence Tomography in Idiopathic Macular Epiretinal Membrane Surgery
Zi-Qing Mao1, Hong-Xi Wu1, Hui-Min Fan1
1Department of Ophthalmology, Affiliated Eye Hospital of Nanchang University, Nanchang, 330006, People's Republic of China.
International Journal of General Medicine
|August 15, 2022
Summary
Intraoperative optical coherence tomography (IOCT) is a safe and effective tool for idiopathic macular epiretinal membrane surgery, reducing the need for internal limiting membrane staining. This technique proves feasible and practical for surgeons.
Area of Science:
- Ophthalmology
- Surgical Innovation
- Medical Imaging
Background:
- Idiopathic macular epiretinal membrane (IMM) surgery traditionally involves internal limiting membrane (ILM) staining.
- The use of ILM staining can lead to complications and is not always necessary.
- Evaluating alternative methods to improve surgical outcomes and safety is crucial.
Purpose of the Study:
- To assess the feasibility and practicality of intraoperative optical coherence tomography (IOCT) in IMM surgery.
- To determine if IOCT can eliminate the need for ILM staining in all patients undergoing IMM surgery.
- To evaluate the impact of IOCT on surgical outcomes and patient vision.
Main Methods:
- A prospective study involving 32 patients (32 eyes) with IMM from July 2018 to June 2020.
- All patients underwent standard 23-gauge vitrectomy with IOCT guidance.
- Internal limiting membrane peeling was performed only when obvious retinal folds were present; ILM staining was avoided.
- Intraoperative and postoperative complications, macular microstructural changes, and best-corrected visual acuity (BCVA) were recorded.
Main Results:
- Complete removal of the epiretinal membrane was achieved in 75% of patients without ILM staining.
- The optimal starting point for membrane stripping was identified using IOCT in 75% of cases within a mean of 66 ± 15 seconds.
- At 3 months post-surgery, 96.8% of patients showed stable or improved BCVA (p < 0.05).
- Central macular thickness significantly decreased at 1 and 3 months post-operation (p < 0.05).
Conclusions:
- Intraoperative optical coherence tomography (IOCT) significantly reduces the necessity for internal limiting membrane staining in IMM surgery.
- IOCT is a safe, feasible, and practical tool for performing idiopathic macular epiretinal membrane surgery without routine ILM staining.
- The adoption of IOCT can enhance surgical efficiency and improve visual outcomes for patients with IMM.
