Purpose: To prospectively compare microvascular changes of internal limiting membrane (ILM) peeled and nonpeeled eyes in patients with idiopathic epiretinal membranes using optical coherence tomography angiography.Methods: Forty-two patients with epiretinal membranes underwent vitrectomy with (n = 22) or without ILM peeling (n = 20). The mean superficial capillary plexus foveal avascular zone area change between preoperative and three-month postoperative readings served as the main outcome measure. Secondary outcome parameters included mean changes in superficial capillary plexus parafoveal vessel density, central foveal thickness, retinal volume, and best-corrected visual acuity.Results: Mean superficial capillary plexus foveal avascular zone area change (mm 2 ) was 59 ± 74 in the ILM nonpeeling group compared with 212 ± 86 in the ILM peeling group (P = 0.007). Similarly, mean superficial capillary plexus parafoveal vessel density change (%) was higher in the ILM nonpeeling group (ILM nonpeeling 4 ± 4, ILM peeling 22 ± 6, P = 0.003). The mean retinal volume reduction was higher in the ILM peeling group, and this difference also reached statistical significance (P = 0.036). There were no intergroup differences in mean central foveal thickness change and mean best-corrected visual acuity change (P = 0.409 and P = 0.440, respectively). Epiretinal membrane/ILM separation was achieved in 23 of 51 patients. Conclusion:The macular microvasculature demonstrated more remodeling in the ILM nonpeeling group after three months.

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Purpose To provide a detailed analysis of risk factors for pseudophakic retinal detachments (PRD) and pseudophakic retinal breaks (PRB). Materials and methods We reviewed the medical records of cataract surgeries between 1996 and 2017 at a tertiary care hospital in Austria. A Cox proportional‐hazard regression model was used to analyse risk factors for PRD and PRB. Results Sixty‐five thousand six hundred and sixty‐two eyes (45 043 patients) underwent phacoemulsification, and 393 eyes (cumulative incidence 0.6%) were diagnosed with PRD (327 eyes) or PRB (66 eyes) during the follow‐up (median 7.1 years, range 0–21). Calculation of adjusted hazard ratios (HR) revealed a hierarchy of risk factors for either event including (from the highest to the lowest risk) posterior capsular rupture (PCR), patient age <65 years (compared with the age group >75 years), male gender and high myopia. Diabetes mellitus was associated with a lower risk. PCR was the strongest risk factor for PRD both in patients with and without perioperative vitrectomy (i.e. vitreous loss), but time to PRD was significantly reduced only following PCR with vitrectomy. Conclusions Posterior capsular rupture, young patient age, male gender and high myopia were risk factors for PRD, but diabetes mellitus was associated with a lower risk. PCR had the strongest association with PRD, regardless of the need for perioperative vitrectomy due to vitreous loss. Time to PRD was reduced in patients with PCR and vitrectomy compared with PCR without the need for vitrectomy or uneventful surgery.

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