Risk factors for onset or progression of epiretinal membrane after cataract surgery

While the precise diagnosis of early stage epiretinal membrane (ERM) at the time of cataract surgery and evaluation of risk factors for development or progression of ERM after cataract surgery is increasingly important, there is only limited information. In the present study, we evaluated the risk factors for onset or progression of ERM on spectral domain optical coherence tomography (SD-OCT) after cataract surgery. The univariate analysis showed that eyes with partial posterior vitreous detachment (PVD; p < 0.001), hyper-reflective foci (HF) on the inner retinal surface (p < 0.001), vitreoschisis (p = 0.014), and discrete margin of different retinal reflectivity (DMDRR; p = 0.007) on ultra-widefield fundus photography (UWF-FP) had significant risk for the onset or progression of ERM after cataract surgery. The multivariate analysis showed that partial PVD (HR, 3.743; 95% confidence interval [CI], 1.956-7.162; p < 0.001), HF (HR, 2.330; 95% CI, 1.281-4.239; p = 0.006), and DMDRR on UWF-FP (HR, 3.392; 95% CI, 1.522-7.558; p = 0.003) were the independent risk factors for the onset or progression of ERM after cataract surgery after adjustment for other confounding factors. Our study shows that the onset or progression of ERM after cataract surgery depends on an abnormal vitreoretinal interface (VRI) represented by partial PVD, HF on SD-OCT, and DMDRR on UWF-FP, not on age, axial length, or presence of ERM at the time of surgery. A meticulous funduscopic evaluation of the VRI would help to predict the ERM risk before cataract surgery.