ETD

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Tesi etd-10162020-083152


Tipo di tesi
Tesi di specializzazione (4 anni)
Autore
SARTINI, FRANCESCO
URN
etd-10162020-083152
Titolo
SECONDARY EPIRETINAL MEMBRANE AFTER EX-PRESS GLAUCOMA FILTRATION DEVICE IMPLANT
Dipartimento
PATOLOGIA CHIRURGICA, MEDICA, MOLECOLARE E DELL'AREA CRITICA
Corso di studi
OFTALMOLOGIA
Relatori
relatore Prof. Figus, Michele
Parole chiave
  • cellophane macular reflex
  • epiretinal membrane
  • Ex-Press glaucoma filtration device
  • glaucoma surgery
  • macular pucker
  • pre-macular fibrosis
  • primary open-angle glaucoma
Data inizio appello
06/11/2020
Consultabilità
Non consultabile
Data di rilascio
06/11/2090
Riassunto
Purpose: To estimate the frequency of epiretinal membrane (ERM) in eyes with primary open-angle glaucoma (POAG) treated with Ex-Press shunt implant. Secondarily, we aimed to assess concomitant cataract surgery's role and the impact of the ERM on the central foveal thickness and macular volume.
Methods: In this prospective, consecutive, case-control study, we enrolled 54 patients affected by PAOG and scheduled for Ex-Press device implant with or without contemporary phacoemulsification. Contralateral eyes affected by POAG and receiving anti-glaucomatous eyedrops constituted the control group. Complete ophthalmologic evaluation and spectral-domain optical coherence tomography (OCT) were performed before and 1,3 and 6 months after surgery.
Results: 26 eyes received the Ex-Press implant alone, and 28 eyes underwent the combined procedure. 6 months postoperatively, we observed 18 (33%) cases of ERM: 15 (28%) of cellophane macular reflex (CMR) and 3 (6%) of pre-macular fibrosis (PMF). In the control group, 9 (17%) eyes developed an ERM: 8 (15%) were CMR, and 1 (2%) was PMF. The frequency of ERM statistically differs between the treated and contralateral eyes (P=0.032, χ2 test). The ERM frequency did not statically differ between eyes subjected to simple or combined surgery (P=0.846, χ2 test). Mean central foveal thickness and mean macular volume did not significantly differ between groups.
Conclusion: The Ex-Press Glaucoma shunt may increase the risk of ERM onset regardless of the concomitant cataract surgery; however, most cases were cellophane macular reflex with limited functional and anatomical impact.
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