[Vitrectomy in the treatment of epimacular membranes (macular pucker)]

The formation of contractile membranes on the inner retinal surface of the macula (macular pucker, epiretinal gliosis) has an increased incidence with age. They also occur in vascular or inflammatory disorders of the posterior segment, after blunt injuries, retinal detachment surgery, and coagulation therapy. Surgical removal of epiretinal membranes in the macula by vitrectomy is performed since 1978. Our analysis of 78 consecutive patients with a postoperative follow-up from 6 to 36 months showed good anatomical and functional results. Visual impairment caused by metamorphopsia decreased in all patients. Visual acuity improved two lines or more in 55 cases (70.5%). 22 (28.2%) were unchanged (including improvement of one line), and one eye (1.3%) became worse. Functional results were significantly better in eyes with macular pucker of less than 6 months duration and with thin, transparent membranes. The age of patients is not likely to play a significant role for functional outcome. Complications were cataracts in 10, retinal defects or detachments in 5 patients, and recurrence of the epiretinal membrane in 2 cases.