ILM peeling, gas tamponade correlated with dissociated optic nerve fiber layer

Issue: November 10, 2016

Internal limiting membrane peeling with intravitreal gas tamponade was associated more strongly with a postoperative dissociated optic nerve fiber layer than peeling alone, a Korean study found.

The retrospective study included 296 eyes of 296 patients who underwent pars plana vitrectomy for epiretinal membrane between 2009 and 2013.

A dissociated optic nerve fiber layer (DONFL) developed in 30 eyes (10.1%, DONFL group) and did not develop in 266 eyes (89.9%, control group). Age of the patients and length of postoperative follow-up were not significantly different between the two groups.

ILM peeling was performed in 29 eyes in the DONFL group (96.7%) and 126 eyes in the control group (47.4%); the between-group difference was statistically significant (P < .001).

Twenty-one eyes in the DONFL group (70%) and 133 eyes in the control group (50%) underwent intravitreal gas tamponade; the between-group difference was statistically significant (P = .038).

ILM peeling and intravitreal gas tamponade correlated significantly with DONFL (P = .001 and P = .042, respectively).

“We believe that intravitreal gas and a postoperative face-down position induced both mechanical and chemical damage to the retinal nerve fiber layer, which was exposed after ILM peeling, resulting in DONFL formation,” the study authors said. – by Matt Hasson

Disclosure: The authors report no relevant financial disclosures.

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Source:

Park SH, et al. Retina. 2016;doi:10.1097/IAE.0000000000000949.