July 16, 2014
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Subjective estimation of ILM peeling surface without dye improves with experience

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Junior and senior surgeons’ ability to subjectively estimate the internal limiting membrane peeling surface without the use of dye was fair; however, surface areas were larger for more-experienced surgeons, researchers found.

In a prospective study, 30 eyes of 30 patients underwent epiretinal membrane surgery; half of the patients had surgery performed by a senior surgeon, and the other half had surgery performed by two junior surgeons. All patients underwent an eye examination, which included measurement for best corrected visual acuity, slit-lamp examination and a dilated fundus ophthalmoscopy.

The surgeons were asked to reach a target internal limiting membrane peeling (ILM) surface with an eccentricity of 1 optic disk diameter, centered on the fovea. ILM peeling surface area was measured during surgery with no dye, and again postoperatively using brilliant blue G staining.

Without dye, the median ILM peeling surface area was 9.3 mm2; after the dye was incorporated, the median area was 7.4 mm2. The ILM peeling surface area was statistically significantly larger in the eyes operated on by the senior surgeon compared with those operated on by the junior surgeons, according to the researchers.

Among patients who underwent surgery with the senior surgeon, 86.7% reached the minimum target area to be peeled (12 mm2) before dye, compared with 46.7% of patients who underwent surgery with the junior surgeons.

Four of 15 patients in the senior surgeon’s group required additional ILM peeling compared with 11 patients in the junior surgeons’ group (P = .03).

Disclosure: The authors have no relevant financial disclosures.