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Surgery for epiretinal membrane using three different surgical platforms: A comparative pilot study.

Vibha Badrinath1, Ashish Markan1, Mohit Dogra2

  • 1Vibha Badrinath and Ashish Markan are combined first authors.

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|May 7, 2025
PubMed
Summary

New technologies like microscope-integrated optical coherence tomography (Mi-OCT) and 3D heads-up display (3D-HUD) reduced surgical time for epiretinal membrane (ERM) peeling but did not improve visual outcomes compared to standard methods.

Keywords:
3D-HUD3D-HUD = 3D head-up displayBCVA = Best-corrected visual acuityERMFFA = Fundus fluorescein angiographyGAT = Goldman applanation tonometryIOP = Intraocular pressureMIOCTMi-OCT = Microscope integrated-OCTOCT = Optical Coherence TomographyPPV = Pars plana vitrectomyRPE = Retinal pigment epitheliumSOM = Standard operating microscopemicroscope integrated OCTstandard operating microscopesurgical outcomes

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Area of Science:

  • Ophthalmology
  • Surgical Technology
  • Retinal Surgery

Background:

  • Epiretinal membrane (ERM) removal is a common vitreoretinal surgery.
  • Dye-assisted peeling is the conventional method, but potential toxicity exists.
  • Advanced visualization tools may improve ERM peeling efficiency.

Purpose of the Study:

  • To compare dye-assisted epiretinal membrane (ERM) peeling using a standard operating microscope (SOM) with peeling without staining using microscope-integrated optical coherence tomography (Mi-OCT) or a 3D heads-up display (3D-HUD) platform.
  • To evaluate the efficacy and safety of novel visualization technologies in ERM surgery.

Main Methods:

  • A prospective, randomized, interventional pilot study.
  • Patients were randomized into three groups: Mi-OCT, 3D-HUD (no dye), and SOM (dye-assisted).
  • Primary outcomes included complete ERM removal rates, complications, and best-corrected visual acuity (BCVA) at 3 months. Secondary outcomes included surgical and peeling times.

Main Results:

  • Complete ERM peeling was achieved in 80% (Mi-OCT) and 70% (3D-HUD) without dye, versus 100% with dye (SOM).
  • No significant difference in BCVA at 3 months was observed across groups.
  • Surgical and ERM peel times were significantly shorter with Mi-OCT and 3D-HUD compared to SOM.

Conclusions:

  • Mi-OCT and 3D-HUD reduce surgical time and the need for staining in ERM peeling.
  • These technologies did not demonstrate an added advantage over standard microscopy in terms of visual acuity at 3 months.
  • Further research is warranted due to the small sample size and short follow-up period.