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Graefe's Archive for Clinical and Experimental Ophthalmology

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01-07-2021 | Cataract | Retinal Disorders

Epiretinal membrane vitrectomy: outcomes with or without cataract surgery and a novel prognostic factor for cystoid macular edema

Authors: Nisa Silva, André Ferreira, João Heitor Marques, Natália Ferreira, Nuno Correia, Bernardete Pessoa, João Melo Beirão, Ferenc Kuhn, Angelina Meireles

Published in: Graefe's Archive for Clinical and Experimental Ophthalmology | Issue 7/2021

Abstract

Purpose

To assess the outcomes of vitrectomy with or without cataract surgery for the treatment of idiopathic ERM in phakic eyes and evaluate predictors of functional and anatomical outcomes.

Methods

Retrospective cohort of consecutive phakic ERM eyes distributed in three groups: a) combined (phacovitrectomy) group, b) PPV-only group, and c) consecutive group (PPV followed by cataract surgery). Main outcomes were final visual acuity (VA) and cystoid macular edema (CME) occurrence. Potential predictors of VA or CME included clinical variables and SD-OCT parameters.

Results

A total of 108 eyes were included in this study. There were no differences in the final VA between consecutive and combined groups (0.22 vs 0.10 logMAR, p = 0.851). Twelve eyes from the combined group (23%) and one eye from the PPV-only group presented CME (p = 0.001). There were no differences between postoperative CME occurrence in combined versus consecutive group (12 vs 7, p = 0.38). The presence of cotton-ball sign predicted the development of CME [OR 2.86 (95%CI 1.01–8.18), p = 0.049] while separated ERM–ILM complex was found to be protective [OR 0.25 (95%CI 0.08-0.77), p = 0.015].

Conclusions

Functional and anatomical results of PPV with ERM and ILM peeling combined with cataract surgery was equivalent to the consecutive procedure, with both strategies being effective. Separated ERM–ILM complex has prognostic value in these patients, as its presence at baseline was found to be protective for postoperative CME.

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Title: Epiretinal membrane vitrectomy: outcomes with or without cataract surgery and a novel prognostic factor for cystoid macular edema
Authors: Nisa Silva
André Ferreira
João Heitor Marques
Natália Ferreira
Nuno Correia
Bernardete Pessoa
João Melo Beirão
Ferenc Kuhn
Angelina Meireles
Publication date: 01-07-2021
Publisher: Springer Berlin Heidelberg
Keywords: Cataract
Edema
Vitrectomy
Peeling
Published in: Graefe's Archive for Clinical and Experimental Ophthalmology / Issue 7/2021
Print ISSN: 0721-832X
Electronic ISSN: 1435-702X
DOI: https://doi.org/10.1007/s00417-021-05076-5

At a glance: The STEP trials

Springer Medicine

Epiretinal membrane vitrectomy: outcomes with or without cataract surgery and a novel prognostic factor for cystoid macular edema

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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