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Long-Term Outcomes After Idiopathic Epiretinal Membrane Surgery

Authors Elhusseiny AM, Flynn Jr HW, Smiddy WE

Received 17 December 2019

Accepted for publication 21 February 2020

Published 31 March 2020 Volume 2020:14 Pages 995—1002


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr Scott Fraser

Abdelrahman M Elhusseiny,1,2 Harry W Flynn Jr,1 William E Smiddy1

1Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA; 2Department of Ophthalmology, Kasr Al-Ainy School of Medicine, Cairo University, Cairo, Egypt

Correspondence: William E Smiddy
Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 900 NW 17 Street, Miami, FL 33136, USA

Purpose: To report anatomic and logMAR best-corrected visual acuity (BCVA) outcomes with long-term follow-up after pars-plana vitrectomy and epiretinal membrane peeling (PPV-MP).
Design: A retrospective case-series.
Participants: Patients with epiretinal membrane (ERM) who underwent PPV-MP performed by one surgeon.
Methods: Best-corrected visual acuity (BCVA) was recorded as a logMAR preoperatively and, when available, at 1, 2, 3, 5, 8, 10 years after surgery. The integrity of outer retinal layers was evaluated using spectral domain optical coherence tomography (SD-OCT).
Main Outcome Measures: Postoperative BCVA at different follow-up visits and its correlation with different OCT parameters.
Results: Fifty-five eyes of 49 patients were followed postoperatively with a mean of 8.6± 2.6 years (median: 9 years, range 5– 16 years). The mean BCVA improved from 0.56± 0.29 (20/72) preoperatively to 0.33± 0.25 (20/42) at 1 year, 0.29± 0.27 (20/38) at 2 years, 0.25± 0.28 (20/35) at 3 years, 0.29± 0.32 (20/38) at 5 years, 0.28± 0.31 (20/38) at 8 years, and  0.28± 0.25 (20/38) at 10 years (p< 0.001). The BCVA improved at each of the first 3 years postoperatively and remained stable at 5, 8, and 10 years. Postoperative improvement in the integrity of ELM, and EZ, on SD-OCT correlated with improved BCVA.
Conclusion: BCVA continues to improve after PPV-MP during the first 3 years postoperatively and remains stable. Improved anatomic integrity of outer retinal layers correlated with improved BCVA.

Keywords: idiopathic epiretinal membrane, outer retinal layer integrity, optical coherence tomography, visual outcomes

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