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Complications of surgery for epiretinal membranes
G Donati1, A D Kapetanios, C J Pournaras
1Department of Clinical Neurosciences, University Hospitals of Geneva, Switzerland.
Purpose:
Surgery has been successful in removing epiretinal membranes (ERM) from the macula, allowing some improvement in vision in 80-90% of patients; however, complications are relatively frequent. We conducted a retrospective study to evaluate the rate of peri- and postoperative complications and their influence on functional outcome of eyes having been operated on for ERM.
Material And Methods:
Preoperative findings, intraoperative and postoperative complications as final results of 70 consecutive cases of idiopathic or secondary ERM operated on by the same retina surgeon were analyzed.
Results:
In all cases the ERMs were successfully removed from the fovea. The mean visual acuity (VA) increased from 0.34 +/- 0.2 to 0.54 +/- 0.31 (P < 0.05) postoperatively. Idiopathic and secondary ERM both showed significant improvement after surgery. Complications included intraoperative hemorrhage and retinal tears and postoperative progressive nuclear sclerosis, retinal tears causing detachments, macular edema and retinal pigmentary epitheliopathy. Final VA was not significantly different from the mean after complications, apart from when retinal detachments involved the macular area.
Conclusions:
Performing surgery for ERM is worthwhile in eyes with major decreased VA and in eyes with metamorphopsia but only moderately reduced vision. Postoperative complications are frequent but can usually be managed successfully. Of them, only retinal detachment has a negative effect on the final functional outcome.
Insights
Epiretinal membrane (ERM) surgery improves vision, but complications can occur. Retinal detachment is the only complication that negatively impacts final visual outcomes after ERM removal.
Area of Science:
- Ophthalmology
- Retinal Surgery
Background:
- Epiretinal membranes (ERMs) can impair vision.
- Surgery for ERM removal offers vision improvement in 80-90% of patients.
- However, surgical complications are a concern.
Purpose of the Study:
- To evaluate the rate of perioperative and postoperative complications.
- To assess the influence of these complications on functional outcomes after ERM surgery.
Main Methods:
- Retrospective analysis of 70 consecutive ERM cases.
- Inclusion of idiopathic and secondary ERMs.
- Analysis by a single retina surgeon.
Main Results:
- Successful ERM removal from the fovea in all cases.
- Mean visual acuity improved significantly postoperatively (0.34 to 0.54).
- Complications included hemorrhage, retinal tears, nuclear sclerosis, macular edema, and pigmentary epitheliopathy. Retinal detachment involving the macula negatively affected final visual acuity.
Conclusions:
- ERM surgery is beneficial for patients with significantly decreased vision or metamorphopsia.
- Postoperative complications are common but generally manageable.
- Retinal detachment is the primary complication impacting long-term visual outcomes.