Complications of surgery for epiretinal membranes

Abstract

Performing surgery for ERM is worthwhile in eyes with major decreased VA and in eyes with metamorphopsia but only moderately reduced vision. Postoperative complications are frequent but can usually be managed successfully. Of them, only retinal detachment has a negative effect on the final functional outcome.

Epiretinal membrane surgery evaluated by subjective outcome

“…In the present study, there was a wide variation in VA preoperatively since there were no restrictions concerning low or high vision, in qualifying patients for surgery. The demography of our patients corresponds well to other studies (Donati et al 1998), as do the result measured by BCVA (Donati et al 1998;Bouwens et al 2008;Cappello et al 2009). …”

“…The selection of VAS as a tool to study the result of peeling ERM was chosen after scrutinizing numerous studies for advises to select patients for surgery but as in the review of Scheerlinck et al (2015) we found no preoperative factors that could predict the subjective outcome from the surgery. Numerous studies have attempted to evaluate the results of surgery merely by assessing the difference in visual acuity (Crafoord et al 1997;Donati et al 1998;Bouwens & Van Meurs 2003). Metamorphopsial measurement has also been used to evaluate the results of removing the ERM.…”

“…Metamorphopsial measurement has also been used to evaluate the results of removing the ERM. Donati et al (1998) evaluated the difference between patients' self-reported symptoms and results simply as relief or decrease of metamorphopsia. Metamorphopsia can also be evaluated using a standard Amsler Chart on which the patient marks the area of distortion (GhaziNouri et al 2006), or with variations of the test using Amsler grids such as the Sinus Amsler Charts to assess the degree of metamorphopsia (Bouwens & Van Meurs 2003).…”

“…However, the most frequently reported complication of ERM is cataract progression, which often requires surgical extraction within 2 years (in our study the average was about 19 months) after the vitrectomy. Thus, the VA results might be influenced by the cataract development and sometimes follow-up shows better BCVA over time when cataract surgery has been performed (Donati et al 1998). In our study, patients who had been lens-operated at the same time as the peeling showed less benefit from the operation measured by the VAS despite the faster recovery of VA compared to in many times an inferior VA in those who developed cataracts after surgery and are were operated at a later time.…”

“…In the decision the patient needs to evaluate the visual impairment attributable to the ERM and the probability that this impairment will be resolved or reduced by peeling the ERM. This possible benefit should be weighed against the risk of complications of the surgery since the procedures have some rare but serious complications such as retinal detachment (Crafoord et al 1997;Donati et al 1998) and endophthalmitis (Scott et al 2011).…”