To evaluate the impact of membrane peeling for idiopathic epiretinal membrane (iERM) on ganglion cell–inner plexiform layer (GCIPL) thickness in eyes with and without primary open-angle glaucoma (POAG). A total of 120 eyes (mean age 67.5 ± 10.0 years, female: 59%) were divided into four groups ( n = 30 each): (1) POAG with iERM that underwent surgery, (2) non-glaucomatous with iERM that underwent surgery, (3) POAG without iERM, and (4) healthy control. Patients with iERM underwent pars-plana vitrectomy (PPV) with ERM and internal limiting membrane (ILM) peeling. GCIPL thickness within a 4 × 4.8 mm elliptical area was measured using Cirrus OCT (ZEISS, Dublin, CA) at baseline, 6 months, and 12 months postoperatively. Data collected included demographic and clinical parameters, best corrected visual acuity (BCVA), and intraocular pressure (IOP). A significant three-way interaction was observed between glaucoma, surgery, and time. POAG with iERM that underwent membrane peeling demonstrated greatest thinning, with mean change of − 9.40 μm at 6 months (95% CI: −15.07, − 3.73) and − 10.37 μm at 12 months (95% CI: −15.77, − 4.97), compared to all other groups ( p < 0.001). BCVA significantly improved in non-glaucomatous eyes that underwent membrane peeling ( p = 0.005), while remaining stable in the other groups. IOP remained stable across all time points. PPV with ILM and ERM peeling is associated with significant GCIPL thinning in glaucomatous eyes. These findings suggest a synergistic effect between glaucoma and surgical intervention, underscoring the need for caution when considering ILM peeling in glaucomatous patients.
Jiang et al. (Mon,) studied this question.
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