Visual and Anatomical Outcomes Following Idiopathic Epiretinal Membrane and Internal Limiting Membrane Peeling

INTRODUCTION: The aim of this study was to evaluate the functional and anatomical outcomes and the rate of epiretinal membrane (ERM) recurrence in eyes that had undergone ERM-internal limiting membrane (ILM) peeling surgery at least 6 months earlier.
METHODS: The records of 81 eyes of 81 patients who underwent pars plana vitrectomy (PPV) and ERM-ILM peeling with the diagnosis of idiopathic ERM between January 2015 and January 2016 in our clinic were retrospectively reviewed. Patients with at least 6 months of follow-up were included. The demographic details of the patients, duration of the follow-up period, use of endotamponade, and any complications were recorded. Best corrected visual acuity and central macular thickness (CMT) at baseline and at 6, 12, and 18 months were also recorded.
RESULTS: A total of 81eyes of 81 patients, 45 (55.6%) males and 36 (44.4%) females, with a group mean age of 65.7±8.5 years (range: 46-85 years) were assessed. The mean preoperative visual acuity was 0.81±0.50 logMAR (the logarithm of the minimum angle of resolution) (0.22 decimals). During the follow-up, the mean visual acuity at 6, 12, and 24 months was 0.61±0.37 logMAR (0.33 decimals), 0.61±0.38 logMAR (0.33 decimals), and 0.55±0.33 logMAR (0.36 decimals), respectively. The visual acuity was significantly better at 6,12, and 24 months compared with the baseline measurement (p<0.05 for all; paired t-test). The mean preoperative CMT was 519±103 μm. During the follow-up, the mean CMT was 302±89 μm, 287±80 μm, and 273±82 μm at 6,12, and 24 months, respectively. Compared with the baseline, a statistically significant difference was observed at 6, 12, and 24 months.
DISCUSSION AND CONCLUSION: PPV with membranectomy and ILM peeling is a safe and effective method to treat idiopathic ERM. It led to a functional improvement and a reduction in macular thickness in most of the patients diagnosed with ERM. The rate of recurrence of ERM and the need for repeat ERM surgery was lower in eyes where the ILM was removed with the ERM than the expected rate for when ERM peeling is performed alone.