25-Gauge Vitrectomy with Epiretinal Membrane and Internal Limiting Membrane Peeling in Eyes with Very Good Visual Acuity

Curr Eye Res. 2016 Oct;41(10):1387-1392. doi: 10.3109/02713683.2015.1114654. Epub 2016 Feb 10.

Abstract

Purpose: To evaluate the efficacy and safety of pars plana vitrectomy (PPV) in patients with epiretinal membrane (ERM) and preoperative visual acuity (VA) of 20/40 or better.

Methods: 44 eyes that underwent PPV and ERM peeling were included in this retrospective study. Data retrieved included demographic information, VA and intraocular pressure (IOP) preoperatively, after 1 month, 6 months and at final visit, presence of metamorphopsia, surgical reports, and occurrence of any complications.

Results: Mean preoperative VA was 20/36 (0.24 ± 0.08 logMAR) and had improved to 20/27 (0.13 ± 0.11 logMAR) at the final follow-up (p < 0.001). Thirty (68.1%) eyes had improved by 1 line of vision or more, and 10 (22.7%) achieved final 20/20 vision. Significant improvement in vision was achieved earlier in eyes that underwent vitrectomy combined with cataract extraction. Preoperative OCT scans demonstrated preserved outer retinal layer structure.

Conclusions: PPV and ERM peeling is a safe and effective procedure in eyes with very good preoperative VA. PPV combined with cataract extraction offers a faster improvement in VA than PPV alone with deferred cataract surgery. PPV should be considered in symptomatic eyes with ERM and VA of 20/40 or better, in order to preserve and even improve the VA.

Keywords: Epiretinal membrane; good visual acuity; vitrectomy.

MeSH terms

  • Adult
  • Aged
  • Basement Membrane / pathology
  • Basement Membrane / surgery*
  • Epiretinal Membrane / diagnosis
  • Epiretinal Membrane / physiopathology
  • Epiretinal Membrane / surgery*
  • Equipment Design
  • Female
  • Follow-Up Studies
  • Humans
  • Intraocular Pressure
  • Male
  • Microsurgery
  • Middle Aged
  • Retina / pathology
  • Retina / surgery*
  • Retrospective Studies
  • Time Factors
  • Tomography, Optical Coherence / methods*
  • Treatment Outcome
  • Visual Acuity*
  • Vitrectomy / instrumentation*