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Epiretinal membrane surgery: an analysis of 2‐step sequential‐ or combined phacovitrectomy surgery on refraction and macular anatomy in a prospective trial
Purpose To assess the impact of combined phacoemulsification‐vitrectomy and sequential surgery for idiopathic epiretinal membrane (ERM) on refractive error (RE) and macular morphology. Methods In this prospective clinical trial, we allocated phakic eyes with ERM to (1) cataract surgery and subsequen...
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Published in: | Acta ophthalmologica (Oxford, England) England), 2018-05, Vol.96 (3), p.243-250 |
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creator | Hamoudi, Hassan Correll Christensen, Ulrik La Cour, Morten |
description | Purpose
To assess the impact of combined phacoemulsification‐vitrectomy and sequential surgery for idiopathic epiretinal membrane (ERM) on refractive error (RE) and macular morphology.
Methods
In this prospective clinical trial, we allocated phakic eyes with ERM to (1) cataract surgery and subsequent pars plana vitrectomy (PPV) (CAT group), (2) PPV and subsequent cataract surgery (VIT group) or (3) phaco‐vitrectomy (COMBI group). Examinations were at baseline, one month after each surgery, and at 3 months and 12 months of follow‐up. Primary outcome was the RE (the difference between predicted and achieved spherical equivalent); secondary outcomes were best‐corrected visual acuity (BCVA), and incidence of cystoid macular oedema (CME) defined as >10% increment of central subfield macular thickness (CSMT).
Results
Sixty‐two eyes were enrolled. The mean RE showed a small myopic shift of −0.36D in all groups 1 month after surgery, decreasing after 12 months to −0.17D. The absolute value of the RE (ARE) ranged 0.49–0.68D after 12 months. In the immediate postoperative period, there was a higher incidence of CME in the CAT group. There was no significant difference in final RE, ARE, BCVA and CSMT between the groups. Four cases (17%) in the CAT group had resolved visual complaints and improved BCVA after cataract surgery resulting in no need for PPV within the follow‐up period.
Conclusion
Surgery for idiopathic ERM in phakic eyes with either phaco‐vitrectomy or sequential surgery are equal approaches with respect to functional‐ (RE, BCVA) and anatomical outcomes (CME, CSMT). However, if starting with cataract surgery, 17% of the cases may not need subsequent PPV. |
doi_str_mv | 10.1111/aos.13572 |
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To assess the impact of combined phacoemulsification‐vitrectomy and sequential surgery for idiopathic epiretinal membrane (ERM) on refractive error (RE) and macular morphology.
Methods
In this prospective clinical trial, we allocated phakic eyes with ERM to (1) cataract surgery and subsequent pars plana vitrectomy (PPV) (CAT group), (2) PPV and subsequent cataract surgery (VIT group) or (3) phaco‐vitrectomy (COMBI group). Examinations were at baseline, one month after each surgery, and at 3 months and 12 months of follow‐up. Primary outcome was the RE (the difference between predicted and achieved spherical equivalent); secondary outcomes were best‐corrected visual acuity (BCVA), and incidence of cystoid macular oedema (CME) defined as >10% increment of central subfield macular thickness (CSMT).
Results
Sixty‐two eyes were enrolled. The mean RE showed a small myopic shift of −0.36D in all groups 1 month after surgery, decreasing after 12 months to −0.17D. The absolute value of the RE (ARE) ranged 0.49–0.68D after 12 months. In the immediate postoperative period, there was a higher incidence of CME in the CAT group. There was no significant difference in final RE, ARE, BCVA and CSMT between the groups. Four cases (17%) in the CAT group had resolved visual complaints and improved BCVA after cataract surgery resulting in no need for PPV within the follow‐up period.
Conclusion
Surgery for idiopathic ERM in phakic eyes with either phaco‐vitrectomy or sequential surgery are equal approaches with respect to functional‐ (RE, BCVA) and anatomical outcomes (CME, CSMT). However, if starting with cataract surgery, 17% of the cases may not need subsequent PPV.</description><identifier>ISSN: 1755-375X</identifier><identifier>EISSN: 1755-3768</identifier><identifier>DOI: 10.1111/aos.13572</identifier><identifier>PMID: 28926197</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Acuity ; Cataracts ; cystoid macular oedema ; Edema ; epiretinal membrane ; Eye ; Eye surgery ; Incidence ; phacovitrectomy ; refractive error ; Surgery ; Visual acuity ; vitrectomy</subject><ispartof>Acta ophthalmologica (Oxford, England), 2018-05, Vol.96 (3), p.243-250</ispartof><rights>2017 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd</rights><rights>2017 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.</rights><rights>Copyright © 2018 Acta Ophthalmologica Scandinavica Foundation</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3882-bd1faeb42f8c103bad299fa3ee56f60cb70a731a951a9f844086b82b41e70c03</citedby><cites>FETCH-LOGICAL-c3882-bd1faeb42f8c103bad299fa3ee56f60cb70a731a951a9f844086b82b41e70c03</cites><orcidid>0000-0003-2933-6504</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28926197$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hamoudi, Hassan</creatorcontrib><creatorcontrib>Correll Christensen, Ulrik</creatorcontrib><creatorcontrib>La Cour, Morten</creatorcontrib><title>Epiretinal membrane surgery: an analysis of 2‐step sequential‐ or combined phacovitrectomy surgery on refraction and macular anatomy in a prospective trial</title><title>Acta ophthalmologica (Oxford, England)</title><addtitle>Acta Ophthalmol</addtitle><description>Purpose
To assess the impact of combined phacoemulsification‐vitrectomy and sequential surgery for idiopathic epiretinal membrane (ERM) on refractive error (RE) and macular morphology.
Methods
In this prospective clinical trial, we allocated phakic eyes with ERM to (1) cataract surgery and subsequent pars plana vitrectomy (PPV) (CAT group), (2) PPV and subsequent cataract surgery (VIT group) or (3) phaco‐vitrectomy (COMBI group). Examinations were at baseline, one month after each surgery, and at 3 months and 12 months of follow‐up. Primary outcome was the RE (the difference between predicted and achieved spherical equivalent); secondary outcomes were best‐corrected visual acuity (BCVA), and incidence of cystoid macular oedema (CME) defined as >10% increment of central subfield macular thickness (CSMT).
Results
Sixty‐two eyes were enrolled. The mean RE showed a small myopic shift of −0.36D in all groups 1 month after surgery, decreasing after 12 months to −0.17D. The absolute value of the RE (ARE) ranged 0.49–0.68D after 12 months. In the immediate postoperative period, there was a higher incidence of CME in the CAT group. There was no significant difference in final RE, ARE, BCVA and CSMT between the groups. Four cases (17%) in the CAT group had resolved visual complaints and improved BCVA after cataract surgery resulting in no need for PPV within the follow‐up period.
Conclusion
Surgery for idiopathic ERM in phakic eyes with either phaco‐vitrectomy or sequential surgery are equal approaches with respect to functional‐ (RE, BCVA) and anatomical outcomes (CME, CSMT). However, if starting with cataract surgery, 17% of the cases may not need subsequent PPV.</description><subject>Acuity</subject><subject>Cataracts</subject><subject>cystoid macular oedema</subject><subject>Edema</subject><subject>epiretinal membrane</subject><subject>Eye</subject><subject>Eye surgery</subject><subject>Incidence</subject><subject>phacovitrectomy</subject><subject>refractive error</subject><subject>Surgery</subject><subject>Visual acuity</subject><subject>vitrectomy</subject><issn>1755-375X</issn><issn>1755-3768</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNp1kc9OHSEUxknTpv5pF30BQ9JNu7gKzAww7oyx2sTEhS66I8CcaTEzwwgzNrPzEXyDvlufxHO96sJEAoGc_PjgOx8hXzjb5zgObMz7vKiUeEe2uaqqVaGkfv9yrn5tkZ2crxmTXMryI9kSuhaS12qb_DsZQ4IpDLajPfQu2QFontNvSMshtQNO2y05ZBpbKv7f3ecJRprhZoZhCrbDCo2J-ti7MEBDxz_Wx9swJfBT7JdnKRoHmqBN1k8hrkUb2ls_dzatH3gkA5bpmGIe8Wq4BTol1P9EPrS2y_D5ad8lVz9Oro7PVucXpz-Pj85XvtBarFzDWwuuFK32nBXONqKuW1sAVLKVzDvFrCq4rStcrS5LpqXTwpUcFPOs2CXfNrL4AbSWJ9OH7KHrsB1xzobXJatqLZlC9Osr9DrOCbuUjWAFU5XiWiL1fUN5dJTRuhlT6G1aDGdmHZrB0MxjaMjuPSnOrofmhXxOCYGDDfA3dLC8rWSOLi43kg_8YKZI</recordid><startdate>201805</startdate><enddate>201805</enddate><creator>Hamoudi, Hassan</creator><creator>Correll Christensen, Ulrik</creator><creator>La Cour, Morten</creator><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-2933-6504</orcidid></search><sort><creationdate>201805</creationdate><title>Epiretinal membrane surgery: an analysis of 2‐step sequential‐ or combined phacovitrectomy surgery on refraction and macular anatomy in a prospective trial</title><author>Hamoudi, Hassan ; Correll Christensen, Ulrik ; La Cour, Morten</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3882-bd1faeb42f8c103bad299fa3ee56f60cb70a731a951a9f844086b82b41e70c03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Acuity</topic><topic>Cataracts</topic><topic>cystoid macular oedema</topic><topic>Edema</topic><topic>epiretinal membrane</topic><topic>Eye</topic><topic>Eye surgery</topic><topic>Incidence</topic><topic>phacovitrectomy</topic><topic>refractive error</topic><topic>Surgery</topic><topic>Visual acuity</topic><topic>vitrectomy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hamoudi, Hassan</creatorcontrib><creatorcontrib>Correll Christensen, Ulrik</creatorcontrib><creatorcontrib>La Cour, Morten</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Acta ophthalmologica (Oxford, England)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hamoudi, Hassan</au><au>Correll Christensen, Ulrik</au><au>La Cour, Morten</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Epiretinal membrane surgery: an analysis of 2‐step sequential‐ or combined phacovitrectomy surgery on refraction and macular anatomy in a prospective trial</atitle><jtitle>Acta ophthalmologica (Oxford, England)</jtitle><addtitle>Acta Ophthalmol</addtitle><date>2018-05</date><risdate>2018</risdate><volume>96</volume><issue>3</issue><spage>243</spage><epage>250</epage><pages>243-250</pages><issn>1755-375X</issn><eissn>1755-3768</eissn><abstract>Purpose
To assess the impact of combined phacoemulsification‐vitrectomy and sequential surgery for idiopathic epiretinal membrane (ERM) on refractive error (RE) and macular morphology.
Methods
In this prospective clinical trial, we allocated phakic eyes with ERM to (1) cataract surgery and subsequent pars plana vitrectomy (PPV) (CAT group), (2) PPV and subsequent cataract surgery (VIT group) or (3) phaco‐vitrectomy (COMBI group). Examinations were at baseline, one month after each surgery, and at 3 months and 12 months of follow‐up. Primary outcome was the RE (the difference between predicted and achieved spherical equivalent); secondary outcomes were best‐corrected visual acuity (BCVA), and incidence of cystoid macular oedema (CME) defined as >10% increment of central subfield macular thickness (CSMT).
Results
Sixty‐two eyes were enrolled. The mean RE showed a small myopic shift of −0.36D in all groups 1 month after surgery, decreasing after 12 months to −0.17D. The absolute value of the RE (ARE) ranged 0.49–0.68D after 12 months. In the immediate postoperative period, there was a higher incidence of CME in the CAT group. There was no significant difference in final RE, ARE, BCVA and CSMT between the groups. Four cases (17%) in the CAT group had resolved visual complaints and improved BCVA after cataract surgery resulting in no need for PPV within the follow‐up period.
Conclusion
Surgery for idiopathic ERM in phakic eyes with either phaco‐vitrectomy or sequential surgery are equal approaches with respect to functional‐ (RE, BCVA) and anatomical outcomes (CME, CSMT). However, if starting with cataract surgery, 17% of the cases may not need subsequent PPV.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>28926197</pmid><doi>10.1111/aos.13572</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-2933-6504</orcidid><oa>free_for_read</oa></addata></record> |
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subjects | Acuity Cataracts cystoid macular oedema Edema epiretinal membrane Eye Eye surgery Incidence phacovitrectomy refractive error Surgery Visual acuity vitrectomy |
title | Epiretinal membrane surgery: an analysis of 2‐step sequential‐ or combined phacovitrectomy surgery on refraction and macular anatomy in a prospective trial |
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