6533b85efe1ef96bd12bf4b2

RESEARCH PRODUCT

TRANSCONJUNCTIVAL NONVITRECTOMIZING VITREOUS SURGERY VERSUS 25-GAUGE VITRECTOMY IN PATIENTS WITH EPIRETINAL MEMBRANE

Teresio AvitabileMichele NicolaiAlfonso GiovanniniMichele ReibaldiCesare MariottiAndrea RussoAndrea SaittaMario Damiano ToroVincenza BonfiglioAntonio LongoFrancesca Viti

subject

Malemedicine.medical_specialtyVisual acuitygenetic structuresmedicine.medical_treatmentVisual AcuityVitrectomylaw.inventionchemistry.chemical_compoundPostoperative ComplicationsRandomized controlled trialRecurrencelawVitrectomyOphthalmologySuture TechniquemedicineHumansretinal breakProspective StudiesProspective cohort studyAgedNuclear sclerosisbusiness.industrySuture TechniquesEpiretinal MembraneRetinalGeneral MedicineMiddle Agedmedicine.diseaseVitreous BodyProspective StudieOphthalmologyExact testchemistrycataractFemalePostoperative Complicationsense organsmedicine.symptomEpiretinal membraneidiopathic epiretinal membranebusinessnonvitrectomizing surgeryConjunctivaHuman

description

Purpose: To compare the clinical outcomes and the rate of complications of 27-gauge transconjunctival nonvitrectomizing vitreous surgery (NVS) and of 25-gauge transconjunctival sutureless vitrectomy surgery for idiopathic epiretinal membrane removal. Methods: In this prospective randomized study, 83 phakic eyes of 83 consecutive patients with an idiopathic epiretinal membrane were randomized to receive 27-gauge NVS (NVS-group) or 25-gauge vitrectomy (Standard-group). Main outcome measures were best-corrected visual acuity, central retinal thickness, nuclear density units' changes, and rate of complications. Results: Thirty-nine eyes of the Standard-group and 40 of the NVS-group were considered in final analysis. Mean best-corrected visual acuity improved significantly in both groups, with a significant better result at 12 months in NVS-group (P 0.039; t-test). Central retinal thickness decreased significantly in both groups (P < 0.001, Tukey test), without significant difference between the two groups at any time point. At 12 months, nuclear density increased significantly in the Standard-group (analysis of variance, P < 0.001), and it did not change in the NVS-group (analysis of variance, P 0.537). Epiretinal membrane recurred in 5.1% of eyes in the Standard-group and in 7.5% of eyes in the NVS-group (Fisher's exact test, P 1.000). Conclusion: The 27-gauge NVS is an effective surgical procedure in eyes with epiretinal membrane and it induces less progression of nuclear sclerosis than 25-gauge vitrectomy.

https://doi.org/10.1097/iae.0000000000000459