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Published on: December 7, 2021
A Comparison of Peel-Induced Maculopathy Following ILM Peeling Using a Microvacuum Pick Versus Forceps
Objective:
To compare peel-induced maculopathy (PIM) using surgical forceps versus the microvacuum pick (MVP).
Methods:
Consecutive eyes undergoing internal limiting membrane (ILM) peeling using either the MVP or forceps were assessed. En face optical coherence tomography (OCT) images at the level of the nerve fiber layer were generated for 6-month postoperative visit. The percentage of the imaged area showing PIM was termed the PIM index. PIM severity was additionally measured using a qualitative PIM severity scale.
Results:
Seventy-four consecutive eyes underwent ILM peeling with either the MVP (36/74; 49%) or forceps (38/74; 51%). At month-6 postoperatively, the mean PIM index for forceps was 7.7% vs 4.7% for the MVP (P < 0.001, R2 = 0.15). At 6 months, 26/38 eyes (68.5%) in the forceps group had either moderate or severe PIM compared to 12/36 eyes (33.3%) in the MVP group (P = 0.001).
Conclusions:
ILM peeling with the MVP resulted in lower PIM severity compared to forceps. [.
Insights
The microvacuum pick (MVP) significantly reduces peel-induced maculopathy (PIM) compared to surgical forceps. This innovative tool offers a safer approach for internal limiting membrane peeling, minimizing retinal damage.
Area of Science:
- Ophthalmology
- Retinal Surgery
- Surgical Innovation
Background:
- Peel-induced maculopathy (PIM) is a complication following internal limiting membrane (ILM) peeling.
- Current ILM peeling techniques, often using surgical forceps, can lead to significant PIM.
Purpose of the Study:
- To compare the incidence and severity of PIM when using the microvacuum pick (MVP) versus traditional surgical forceps for ILM peeling.
Main Methods:
- A comparative study assessed consecutive eyes undergoing ILM peeling with either the MVP or forceps.
- En face optical coherence tomography (OCT) images were analyzed at 6 months postoperatively.
- The PIM index (percentage of imaged area with PIM) and a qualitative PIM severity scale were used for assessment.
Main Results:
- Eyes peeled with the MVP showed a significantly lower mean PIM index (4.7%) compared to forceps (7.7%) (P < 0.001).
- Moderate or severe PIM was observed in 33.3% of MVP-treated eyes versus 68.5% of forceps-treated eyes (P = 0.001).
Conclusions:
- ILM peeling with the MVP results in substantially lower PIM severity compared to surgical forceps.
- The MVP represents a promising advancement for reducing iatrogenic retinal damage during ILM peeling procedures.
