Complete epiretinal membrane separation in highly myopic eyes with retinal detachment resulting from a macular hole - 09/09/11
, Yasushi Ikuno, MD b, c, Masanobu Motokura, MD a, Kazuto Nakae, MD b, Yasuo Tano, MD cAbstract |
PURPOSE: Epiretinal membranes (ERMs) in highly myopic eyes may result in macular holes and subsequent retinal detachment. However, removing friable, thin ERMs from detached retinas is often difficult. We report the efficacy of a diamond-dusted silicone cannula in the removal of ERMs from detached retinas.
METHODS: Seventeen consecutive highly myopic eyes (16 patients) with retinal detachment underwent pars plana vitrectomy with gas tamponade. Peeling of the ERM adjacent to the macular hole was performed using either conventional tools (n = 11) or a diamond-dusted silicone cannula (n = 6). The rate of complete membrane peeling and the effect of membrane removal on the anatomic success rate were compared between groups.
RESULTS: Retinal reattachment occurred in 13 (92.9%) of the 14 eyes in which the ERM was removed completely; redetachment occurred in the other three eyes, with further surgical interventions in two eyes. The reattachment rate was significantly higher (P = .005) when ERM removal was complete than when there was residual ERM. In the initial surgery, the ERM was successfully removed in all 6 eyes (100%) in the diamond-dusted silicone cannula group and in 5 of 11 eyes (45.5%) in the conventional group (P = .041); the reattachment rate was 100% in the diamond-dusted silicone cannula group and 45.5% in the conventional group (P = .005). When a second surgery was performed, the use of the diamond-dusted silicone cannula was also better than conventional tools for removing the residual ERMs, resulting in retinal reattachment.
CONCLUSION: In highly myopic eyes with a macular hole and subsequent retinal detachment, complete ERM removal is closely related to successful retinal reattachment. The diamond-dusted silicone cannula appears to be more effective than conventional tools for removing ERM and may increase the anatomic success rate. Because of the limitations of a small series, a prospective, randomized trial is required to confirm the current beneficial results of using a diamond-dusted silicone cannula.
Le texte complet de cet article est disponible en PDF.Plan
Vol 126 - N° 5
P. 669-676 - novembre 1998 Retour au numéro
Article précédent
- Comparison of pneumatic retinopexy and scleral buckling in the management of primary rhegmatogenous retinal detachment
- Dennis P. Han, Naazli C. Mohsin, Clare E. Guse, Arthur Hartz, Cynthia N. Tarkanian, the Southeastern Wisconsin Pneumatic Retinopexy Study Group∗A complete listing of the Southeastern Wisconsin Pneumatic Retinopexy Study Group appears at the end of the article. ∗
- Thrombin–antithrombin III complex in acute retinal vein occlusion
- Hiroyuki Iijima, Takashi Gohdo, Masahito Imai, Shigeo Tsukahara
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?