Complete epiretinal membrane eparation in highly myopic eye with retinal detachment reulting from a macular hole Original Reearch Article

PURPOE: Epiretinal membrane (ERM) in highly myopic eye may reult in macular hole and ubequent retinal detachment. However, removing friable, thin ERM from detached retina i often difficult. We report the efficacy of a diamond-duted ilicone cannula in the removal of ERM from detached retina. METHOD: eventeen conecutive highly myopic eye (16 patient) with retinal detachment underwent par plana vitrectomy with ga tamponade. Peeling of the ERM adjacent to the macular hole wa performed uing either conventional tool (n = 11) or a diamond-duted ilicone cannula (n = 6). The rate of complete membrane peeling and the effect of membrane removal on the anatomic ucce rate were compared between group. REULT: Retinal reattachment occurred in 13 (92.9%) of the 14 eye in which the ERM wa removed completely; redetachment occurred in the other three eye, with further urgical intervention in two eye. The reattachment rate wa ignificantly higher (P = .005) when ERM removal wa complete than when there wa reidual ERM. In the initial urgery, the ERM wa uccefully removed in all 6 eye (100%) in the diamond-duted ilicone cannula group and in 5 of 11 eye (45.5%) in the conventional group (P = .041); the reattachment rate wa 100% in the diamond-duted ilicone cannula group and 45.5% in the conventional group (P = .005). When a econd urgery wa performed, the ue of the diamond-duted ilicone cannula wa alo better than conventional tool for removing the reidual ERM, reulting in retinal reattachment. CONCLUION: In highly myopic eye with a macular hole and ubequent retinal detachment, complete ERM removal i cloely related to ucceful retinal reattachment. The diamond-duted ilicone cannula appear to be more effective than conventional tool for removing ERM and may increae the anatomic ucce rate. Becaue of the limitation of a mall erie, a propective, randomized trial i required to confirm the current beneficial reult of uing a diamond-duted ilicone cannula.