Intraoperative Foveal Traction in Patients with Epiretinal Membrane


Intraoperative Foveal Traction in Patients with Epiretinal Membrane by Hee Seong Yoon, Hye Min Jeon, Heon Yang, Sue Hey Chae, Soh Eun Ahn, South Korea



To determine influence of intraoperative foveal traction during membrane peeling in idiopathic epiretinal membrane(ERM) surgery.


This retrospective observational study included 46 eyes of 46 patients with idiopathic ERM, who underwent pars plana vitrectomy with ERM and internal limiting membrane (ILM) peeling from February 2015 to September 2015. Presence of intraoperative foveal traction during membrane peeling was reviewed using video records. The main outcome measures were best corrected visual acuity (BCVA) and central foveal thickness (CFT), foveal contour, photoreceptor inner segment/outer segment (IS/OS) junction disruption using optical coherence tomography (OCT) at baseline; at 1, 3, 6, and 12 months after surgery.


Group 1 (ERM with intraoperative foveal traction) included 22 eyes, and group 2 (ERM without intraoperative foveal traction) included 24 eyes. Preoperatively, convex pattern ERM was observed more often in Group 1. Group 1 had a significantly thicker CFT and a lower BCVA compared to group 2 at baseline and during the first 6 months, but final postoperative BCVA and CFT were not significantly different between the groups at 12 months. Among 22 eyes, 12 eyes (54.5%) restored to flat or concave ERM pattern at an average of 5.4 months after surgery at group 1, 18 out of 24 eyes (75%) recovered at 2.4 months (p<0.01) at group 2.


Preoperative thick CFT and convex pattern ERM indicate a high possibility of intraoperative foveal traction in idiopathic ERM surgery. According to foveal traction during membrane peeling, postoperative BCVA and restoration of foveal configuration showed different course in the first 6 months. However, final results were not significantly different at the last follow-up.


Hee Seong Yoon
Busan, South Korea
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