VISUAL ACUITY LOSS AFTER VITRECTOMY FOR EPIRETINAL MEMBRANE IN EYES WITH GLAUCOMA

To investigate the incidence and predictors of visual acuity loss after surgery for epiretinal membrane in glaucomatous eyes.

A prospective cohort study examining visual acuity and central visual fields (VFs, Humphrey 10-2) at baseline and 3, 6, and 12 months after vitrectomy with internal limiting membrane peeling for epiretinal membrane in the glaucoma (47 eyes of 43 patients) and control (46 eyes of 46 patients) groups. Visual acuity and VF tests were repeated for ≥1.5 years only for the glaucoma group. Factors associated with substantial visual acuity loss (>0.2 logarithm of the minimal angle of resolution [approximately >2 lines on the Snellen chart] from baseline) were determined using a Cox proportional hazards model.

Until 1 year postoperatively, no substantial visual acuity loss occurred and postoperative visual acuity improved significantly and similarly in both groups ( P < 0.001 vs. baseline, P > 0.15 between 2 groups). Substantial visual acuity loss occurred in 8 eyes (17%) with glaucoma ≥1.5 years postoperatively, which was associated with worse preoperative VF mean deviation and 1-year mean decrease in postoperative VF mean deviation (hazard ratio = 0.83-0.72; P = 0.018, <0.001, respectively).

Substantial visual acuity loss occurred long after epiretinal membrane surgery in eyes with glaucoma, which was associated with worse preoperative central VFs and greater central VF deterioration during the first postoperative year.