Evaluation of Factors Affecting Epiretinal Membrane Surgery Outcomes

INTRODUCTION: The aim of this study was to evaluate several factors affecting the outcome of epiretinal membrane (ERM) surgery.
METHODS: The data of a total of 41 eyes of 40 patients (20 female, 20 male) who underwent pars plana vitrectomy (PPV) and epiretinal membrane (ERM) peeling with/without internal limiting membrane (ILM) peeling between November 2001 and October 2005 at Beyoðlu Eye Training and Research Hospital with a minimum follow-up of 6 months were included in this retrospective study. The patients' best corrected visual acuity (BCVA; Snellen) and the biomicroscopic, funduscopic, and optical coherence tomography (OCT) findings measured preoperatively and at month 1,3,6, and a final visit were recorded. The surgical technique (partial 25-gauge vs 20-gauge), ILM peeling, intraoperative dyes, and the etiology of the ERM were evaluated as separate factors in the surgical outcome. Intraoperative, peroperative, and postoperative complications were assessed and compared.
RESULTS: The mean age of the study group participants was 63.56±14.96 years. The mean BCVA had increased from 0.28±0.149 to 0.35±0.24 Snellen lines (p=0.028) at the 6-month visit. In all, 18 of 41 eyes (43.9%) had gained ≥2 Snellen lines at the final visit. Cataract progression was detected in 17 cases (54.8%) of phakic eyes. The incidence of ERM recurrence was significantly greater in the ILM Intact group (37% vs 0%) than in the ILM Peeled group (p=0.009). There was no significant difference in anatomical or functional outcome between the partial 25-gauge and 20-gauge PPV techniques.
DISCUSSION AND CONCLUSION: ILM peeling significantly reduced ERM recurrence. Follow-up observations indicated that cataract progression was the primary factor limiting visual gain.