Long Term Outcomes after Pars Plana Vitrectomy for the Treatment of Epiretinal Membranes

Abstract

Purpose: To report the long-term outcomes of surgical treatment of epiretinal membranes (ERM) with pars plana vitrectomy (PPV) and internal limiting membrane (ILM) peeling.Methods: This was a retrospective interventional case series of patients with symptomatic ERM. 340 eyes of 322 patients were included in the study. Mean age of the sample was 68±12 years. Preoperative and postoperative Corrected Distance Visual Acuity (CDVA), as well as Intraocular Pressure (IOP) measurements were compared, Central Macular Thickness (CMT) from Optical Coherence Tomography (OCT) was correlated with CDVA at all time intervals. Results:No intraoperative or immediate postoperative complications were observed. Mean preoperative CDVA was 0.6±0.3 logMAR. Statistically significant improvement was noted at all postoperative follow ups (P<0.002). Mean postoperative CDVA at last follow up visit was 0.2±0.2 logMAR. The rate of CDVA's improvement was 67%. IOP measurements showed a statistically significant increase at the 1st postoperative month and then approached the preoperative values, without statistical significance. Mean CMT measurements showed gradual reduction at all follow up visits, from 427±91μm to 268±40μm at the last visit (P<0.0001). The preoperative CMT was statistically significant correlated with pre-and postoperative CDVA at the 6th month, 1 year and last follow up visit (p<0.05). Statistically significant correlations were also found between 1 month postoperative CMT and 1 year postoperative CDVA (P<0.02). CDVA at the last examination was significant correlated with postoperative CMT at 1 month, 6 months (P<0.0001). After multivariate linear regression, postoperative CMT at 1st month, 6th months and 1 year was correlated with CDVA at the last follow up examination. Conclusion:PPV with ILM peel is a justifiable intervention for patients with ERMs, which may offer CDVA improvement and continuous regularization of foveal anatomy through the next years.

<p>Outcomes of Epiretinal Membrane Removal Utilizing Triamcinolone Acetonide Visualization and Internal Limiting Membrane Forceps</p>

“…Although preoperative values are highly varied among prior studies, they all demonstrated similar improvements with one year postoperative vision ranging between 0.180 and 0.690 logMAR (Snellen 20/30 to 20/100) and CMT 268-375µm. 9,10,[13][14][15] BCVA at five years was 0.109±0.029 logMAR (Snellen 20/25), which is better than another study reporting outcomes of ERM surgery with ICG visualization (0.449±0.487logMAR; Snellen 20/60). 2 Dawson et al demonstrated that surgical intervention on patients with better preoperative BCVA yields a better final BCVA and patients with poorer preoperative BCVA showed a greater change in BCVA following ERM surgery.…”