Evaluation of Epiretinal Membrane Formation Following Pars Plana Vitrectomy for Primary Rhegmatogenous Retinal Detachment using Optical Coherence Tomography

Track:
Retina
What:
Paper Presentation | Présentation d'article
When:
11:16 AM, Saturday 11 Jun 2022 (5 minutes)
How:

Authors: Samir Touma, Andrei-Alexandru Szigiato, Fares Antaki, Simon Javidi, Renaud Duval, Ghassan Cordahi, Sebastien Olivier, Flavio Rezende. 

Author Disclosure Block: S. Touma: All other investments or relationships that could be seen by a reasonable, well-informed participant as having the potential to influence the content of the educational activity; Name of for-profit or not-for-profit organization(s); Bayer Inc.. All other investments or relationships that could be seen by a reasonable, well-informed participant as having the potential to influence the content of the educational activity; Description of relationship(s); Research grant. A. Szigiato: None. F. Antaki: Any direct financial payments including receipt of honoraria; Name of for-profit or not-for-profit organization(s); SNELL Medical Communication Inc.. Any direct financial payments including receipt of honoraria; Description of relationship(s); Honoraria. All other investments or relationships that could be seen by a reasonable, well-informed participant as having the potential to influence the content of the educational activity; Name of for-profit or not-for-profit organization(s); Bayer Inc.. All other investments or relationships that could be seen by a reasonable, well-informed participant as having the potential to influence the content of the educational activity; Description of relationship(s); Research grant. S. Javidi: None. R. Duval: All other investments or relationships that could be seen by a reasonable, well-informed participant as having the potential to influence the content of the educational activity; Name of for-profit or not-for-profit organization(s); Alcon, Novartis, Bayer, Roche. All other investments or relationships that could be seen by a reasonable, well-informed participant as having the potential to influence the content of the educational activity; Description of relationship(s); Research grants. G. Cordahi: None. S. Olivier: None. F. Rezende: None.


Purpose: To evaluate the rate and risk factors of epiretinal membrane (ERM) formation requiring surgical removal after pars plana vitrectomy (PPV) for primary rhegmatogenous retinal detachment (RRD). 

Study Design: Multi-surgeon retrospective cohort study including 167 consecutive eyes of 167 patients who underwent PPV for primary RRD. Methods: Procedures were performed at the Maisonneuve Rosemont Hospital in Montreal Canada, from Dec 2012 to August 2015. Patients were excluded if they had prior retinal detachment, underwent scleral buckling or preoperative proliferative vitreoretinopathy (grade B or C). The main outcome measure was rate of ERM requiring PPV with ILM peeling. ERMs were graded using an established optical coherence tomography guided grading system. Visual acuity (VA), complications, including re-detachment, and risk factors for surgical ERM formation were also identified 

Results: Mean follow-up was 1028±773 days (±SD) and 78 eyes (47%) were phakic. There were 80 (47.9%) eyes with postoperative ERM formation; 66 (39.5%) type 1, 10 (6.0%) type 2, 3 (1.8%) type 3, and 1 (0.6%) type 4. Only 14 (8.4%) eyes required repeated PPV for a visually significant ERM, with a mean time to reoperation of 318±269 days. The primary risk factor associated with ERM requiring surgical removal was intraoperative cryotherapy (HR= 4.5, 95% CI 1.5-13.5, p<0.01). There was a trend for eyes with more than 4 tears (HR=4.0 (0.9-17.8), p=0.07) and macula off detachments (HR=3.5 (0.8-15.7), p=0.10) to have higher rates of ERM surgery. Re-detachment occurred in 29 (17.4%) eyes 

Conclusions: Visually significant ERM formation following 25g PPV for primary uncomplicated RRD is uncommon. The formation of visually significant ERMs is increased by intraoperative cryotherapy and possibly by detachments with more than 4 tears or that are macula off. The authors do not recommend prophylactic ILM peeling in eyes with primary uncomplicated RRD.

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