Epiretinal Membrane Clinical Trial
Official title:
Comparison of Two Techniques for Epiretinal or Internal Limiting Membrane Peel.
Epiretinal membranes (ERM) are cellular membranes on the surface of the retina that result
in distortion of the vision (metamorphopsia), and decreased best-corrected visual acuity.
They are most frequently found in patients over the age of 50 and have a reported prevalence
of 7-12%. [1,2] Epiretinal membranes are caused by posterior vitreous separation, retinal
detachment, proliferative vitreoretinopathy, cataract surgery, trauma, inflammation, retinal
vascular disease, and idiopathic. [1-4] Epiretinal membrane removal by pars plana vitrectomy
combined with internal limiting membrane peeling leads to improved vision, decreased
metamorphopsia, and improved quality of life after surgery. [2] Internal limiting membrane
(ILM) peel has been associated with decreased rates of epiretinal membrane recurrence and is
also performed during vitrectomy for repair of macular holes or vitreomacular traction.
[5,6] Internal limiting membrane peeling can be performed by using an instrument to make a
break in the membrane followed by peeling with forceps, or by utilizing ILM forceps alone to
pinch and peel an unviolated ILM. No study exists comparing different intraoperative
techniques used for ILM peeling on visual outcomes and operating time. The investigators
hypothesize that using a "pinch and peel" technique will equal outcomes with shorter
operating time than other techniques.
1. McDonald HR, Johnson RN, Ai E, Jumper JM, Fu AD. Macular epiretinal membranes. Retina,
4th edition, editor Ryan SJ, Wilkinson CP, 2006, p 2509-2525.
2. Ghazi-Nouri SM, Tranos PG, Rubin GS, Adams ZC, Charteris DG. Vitrectomy and epiretinal
membrane peel surgery visual function and quality of life following. 2006;90;559-562;
Br. J. Ophthalmol
3. Haritoglu C, Gandorfer A, Gass CA, Schaumberger M, Ulbig MW, Kampik A. The Effect of
Indocyanine-Green on Functional Outcome of Macular Pucker Surgery. AM. J. Ophthal. VOL.
135,NO.3, 328-337, Mar 2003
4. Hiscott PS, Grierson I, McLeod D. Retinal pigment epithelial cells in epiretinal
membranes: an immunohistochemical study. Br. J. Ophthalmol, 1984, 68, 708-715
5. Park DW, Dugel PU, Garda J, Sipperley JO, Thach A, Sneed SR, Blaisdell J. Macular
Pucker Removal with and without Internal Limiting Membrane Peeling: Pilot Study.
Ophthalmology Volume 110, 1, Jan 2003
6. Kwok AK, Lai TY, Yuen KS. Epiretinal membrane surgery with or without internal limiting
membrane peeling. Clinical and Experimental Ophthalmology, 2005, 33:379-385
n/a
Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Single Blind (Subject)
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