Nonvitrectomizing vitreous surgery: A strategy to prevent postoperative nuclear sclerosis☆
Section snippets
Materials and methods
From December 1995 through June 1997, 21 patients with idiopathic EMP underwent unilateral nonvitrectomizing vitreous surgery at our institution. Eyes chosen for surgery had epiretinal membranes within the temporal arcades and symptoms of visual loss or metamorphopsia. Patients who had undergone previous intraocular surgery or had a history of other ocular disorders in the EMP eye and patients with asymmetric lens opacities in the two eyes were excluded from the study. Eyes that had more than a
Results
We performed nonvitrectomizing vitreous surgery in 21 eyes of 21 patients with EMP. There were 5 men and 16 women, ranging in age from 51 to 77 years (mean, 62.0 years). We randomly assigned 11 eyes to group 1 (membrane left floating in the vitreous cavity), and 10 eyes to group 2 (membrane removed from the eye). The follow-up period ranged from 6 to 24 months (mean, 9.7 months). Nineteen of the 21 eyes had final visual acuity equal to or better than preoperative levels (Fig 1).
There were no
Discussion
Nonvitrectomizing vitreous surgery under ordinary set-up was first described by Charles15 in 1987. He described membrane peeling and excision without removal of the vitreous in patients with EMP and small membranes but recommended core vitrectomy when membranes were larger and denser. Charles later abandoned nonvitrectomizing surgery because of initial postoperative floaters and vitreous opacities (personal communication, 1997).
Some hypotheses have been proposed regarding the possible causes of
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Cited by (56)
International Board Members of the American Journal of Ophthalmology
2019, American Journal of OphthalmologyCitation Excerpt :He was known as one of the leading scientists and a pioneer in vitreoretinal surgery and developed numerous surgical techniques and instruments that are currently used worldwide.20,21 He promoted nonvitrectomizing vitreous surgery,22–25 macular translocation surgery,26,27 triamcinolone for proliferative vitreoretinopathy,28 and the artificial vision project.29 He was the president of the Asia-Pacific Academy of Ophthalmology, club Jules Gonin, Japanese Ophthalmological Society.
Epiretinal membranes
2012, Retina Fifth EditionNon-vitrectomizing vitreous surgery and adjuvant intravitreal tissue plasminogen activator for non-recent massive premacular hemorrhage
2011, Journal of the Chinese Medical AssociationCitation Excerpt :Laser membranotomy, which creates an opening to drain the hemorrhage, is reported effective in patients with premacular hemorrhage of no longer than 21 days’ duration; however, it may have limited effects and take longer to drain in patients with hemorrhages of more than two weeks’ duration.7 In 1999, Saito et al.8 advocated nonvitrectomizing vitreous surgery for macular pucker to prevent postoperative nuclear sclerosis; the procedure consisted of epi-retinal membrane peeling without cutting or removing the vitreous. We applied this concept to manage premacular hemorrhage, and a bent needle was used to create a membranotomy to immediately drain the blood into the vitreous cavity.
Comparison of therapeutic effects of non-vitrectomy versus vitrectomy for idiopathic epiretinal membrane
2022, Chinese Journal of Ocular Fundus DiseasesAn objective evaluation of lens transparency after vitrectomy surgery with different intravitreal tamponades
2022, International OphthalmologyMacular Epiretinal Membrane Surgery
2022, Albert and Jakobiec's Principles and Practice of Ophthalmology: Fourth Edition
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Supported by the Grants-in-Aid for Scientific Research (#07557263) from the Ministry of Education, Science and Culture, and Health Science Research Grants, Japan.