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Related Experiment Video

Updated: Nov 11, 2025

A Step by Step Protocol for Subretinal Surgery in Rabbits
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Surgery for idiopathic epiretinal membrane.

Ammar M Yusuf1,2, Mukhtar Bizrah2, Catey Bunce3

  • 1UCL Institute of Ophthalmology, London, UK.

The Cochrane Database of Systematic Reviews
|March 24, 2021
PubMed
Summary

For mild epiretinal membrane, watchful waiting may be as effective as immediate surgery. Further research is needed to confirm these findings for visual acuity and quality of life outcomes.

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Area of Science:

  • Ophthalmology
  • Retinal Surgery
  • Evidence-Based Medicine

Background:

  • Epiretinal membrane (ERM) is abnormal tissue on the retina, potentially impairing vision due to architectural distortion.
  • Understanding the efficacy of surgical intervention versus non-intervention is crucial for managing ERM.

Purpose of the Study:

  • To evaluate the effects of surgical intervention compared to no intervention for epiretinal membrane.
  • To determine optimal management strategies for mild symptomatic epiretinal membrane.

Main Methods:

  • Systematic search of multiple databases including CENTRAL, MEDLINE, Embase, and clinical trial registries.
  • Inclusion of randomized controlled trials (RCTs) comparing idiopathic epiretinal membrane surgery to placebo, no treatment, or sham treatment.
  • Assessment of outcomes including best-corrected visual acuity (BCVA), visual acuity gain/loss, quality of life, and adverse events.

Main Results:

  • One RCT involving 53 participants with mild symptomatic ERM was included.
  • At 12 months, immediate surgery showed a trend towards higher visual acuity (2.1 ETDRS letters) compared to watchful waiting, but with low-certainty evidence.
  • Evidence for visual acuity gain was very uncertain; no significant visual loss occurred in either group. Quality of life was not assessed, and one case of cystoid macular edema was reported post-surgery.

Conclusions:

  • No RCT directly compared surgery to no intervention for ERM.
  • For mild symptomatic ERM, low-certainty evidence suggests watchful waiting or deferred surgery may yield comparable outcomes to immediate surgery.
  • Further high-quality RCTs are necessary to confirm these findings, focusing on robust methodology and comprehensive outcome measures.