Success of iOCT in surgical management of ERM peeling

Abstract

Purpose Epiretinal membranes (ERM) are a disorder leading to progressive vision loss and metamorphopsia. The ERM is treated through a pars-plana vitrectomy (PPV) with membrane peeling. The aim of this study was to define the success of intraoperative optical coherence tomography ( iOCT) in ERM surgery to standard surgical visualization techniques and enhance our current approach to clinical practice. Methods This study included 56 eyes of 54 patients who underwent surgical intervention for management of idiopathic ERM. Patients were recruited between February 2018 and March 2020 at “Francesco Miulli” Hospital ophthalmology department in Acquaviva delle Fonti, Bari, Italy. Results in 28 eyes, ERM peeling was performed without staining and without iOCT; 25% of these eyes peeling ERM (n   =   7) was performed easily, while 75% of eyes peeling ERM (n   =   21) was not possible without staining and was necessary staining with Brillant Blu G. In 28 eyes ERM peeling were performed with iOCT; in 92.5% of these eyes (n   =   26) ERM peeling was easily done without staining, while in 7.5% of this group of eyes (n   =   2) ERM peeling was not possible without staining. Conclusions Our study shows how iOCT has successfully assisted the surgeon to complete peeling in most of the cases treated without the use of a chromovitrectomy dye; in flat ERM was more difficult and iOCT failed to visualize the inner limiting membrane (ILM).