Abstract:

Objective   To evaluate the effect of pars plana vitrectomy with inner limiting membrane (ILM) peeling and intravitreal triamcinolone acetonide (TA) injection in treatment of idiopathic macular epiretinal membrane(IMEM). Methods      Patients were recruited from ophthalmic center from January 2011 to March 2013. Totally, 27 eyes (27 consecutive patients) with IMEM who underwent standard three-port pars plana vitrectomy and epiretinal membrane peeling were observed. Each patient received 4mg TA intravitreal injection at the end of the surgery. All the patients were examined by visual acuity (VA), fundus color photography, and optical coherence tomography (OCT) before and after the treatment. VA was adopted 5 points record； fundus color photography and OCT were taken as usual way．The mean of VA was(4.15±0.32) and the mean of macular thickness was(498±132)μm before the treatment. All the patients were followed-up 3 to 20 months (mean(10±7)months). Results       VA improvement was achieved in 14 eyes(51.85%)，  meanwhile， 9 eyes(33.33%)were stable and 4 eyes(14.81%) were worse． The mean VA increased from (4.15±0.32)to(4.52±0.29)post-operatively， the difference was statistically significant(t＝3.28, P＜0.05)． Simultaneously, metamorphopsia of 13 eyes disappeared, of 10 eyes alleviated and of 4 eyes aggravated. Mean macular thickness decreased from(498±132)μm to(296±114)μm post-operatively， the difference was statistically significant(t＝6.468， P＜0.01). The OCT and fundus photography showed that all the MEM had disappeared. No MEM recurrence and endoephthalmitis were observed during the follow-up periods.  6 eyes(22.22%)had retinal hemorrhage intra-operatively. 7 eyes(25.92%) had cataract improvement and 4 eyes(14.81%) had secondary higher intraocular pressure post-operatively. Conclusion       Pars plana vitrectomy with inner limiting membrane (ILM) peeling and intravitreal TA injection is successful in treating IMEM.

Key words: Idiopathic macular epiretinal membrane, Vitrectomy, Inner limiting membrane , Triamcinolone Acetonide, peeling