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Lookup NU author(s): Roxane Hillier, Maged Habib, Professor David SteelORCiD
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
© 2022, The Author(s). Purpose: To assess study design and a range of anatomical and functional changes after internal limiting membrane (ILM) peeling using forceps developed for atraumatic ILM pick-up compared to standard forceps. Methods: We conducted a masked proof-of concept randomised controlled trial (RCT) on 65 patients who underwent ILM peeling for idiopathic full-thickness macular hole (FTMH) using etched-tip forceps (etched-tip group, 33 eyes) compared to standard ILM forceps (smooth-tip group, 32 eyes). Patients were assessed preoperatively, 3 weeks, 3 and 6 months postoperatively. Results: The primary closure rate was 95.4%. There was no statistically significant difference between the groups in terms of final visual acuity (66.9 vs 70.9 ETDRS letters, p = 0.13), difference of visual field mean deviation (1.32 vs 1.14 decibels), and number of eyes with pick-up-related retinal haemorrhages (16% vs 16%, p = 0.96), swelling of arcuate nerve fibre layer lesions (63% vs 55%, p = 0.54), number of dissociated optic nerve fibre layer lesions (31.4 vs 41.0, p = 0.16), nor inner retina defects (37% vs 22%, p = 0.17). Similar changes in inner retinal volumes were detected in all 9 sectors of an ETDRS grid except for a trend (p = 0.06) towards a lower reduction in the inferior inner sector in the etched-tip group. Conclusions: The study was successfully completed with masking maintained and a low risk of bias. Multiple endpoints relating to ILM peeling were assessed, and estimates were provided that can be used for future studies. Although the study was not powered to assess any specific endpoint, the anatomical and functional outcomes assessed did not significantly differ.
Author(s): Ferrara M, Rivera-Real A, Hillier RJ, Habib M, Kadhim MR, Sandinha MT, Curran K, Muldrew A, Steel DHW
Publication type: Article
Publication status: Published
Journal: Graefe's Archive for Clinical and Experimental Ophthalmology
Year: 2023
Volume: 261
Pages: 1553-1562
Print publication date: 01/06/2023
Online publication date: 13/12/2022
Acceptance date: 27/11/2022
Date deposited: 05/01/2023
ISSN (print): 0721-832X
ISSN (electronic): 1435-702X
Publisher: Springer Science and Business Media Deutschland GmbH
URL: https://doi.org/10.1007/s00417-022-05932-y
DOI: 10.1007/s00417-022-05932-y
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