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Brian Lehpamer, Petros Carvounis; Pars Plana Vitrectomy Epiretinal Membrane Peeling Surgery in Eyes with 20/50 or better visual acuity. Invest. Ophthalmol. Vis. Sci. 2014;55(13):1134.
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To evaluate visual outcomes of pars plana vitrectomy with membrane peel for symptomatic epiretinal membrane (ERM) with good pre-operative visual acuity (20/50 or better).
A retrospective chart review study of patients with pre-operative best corrected visual acuity (BCVA) 20/50 or better who underwent pars plana vitrectomy with membrane peel for ERM at our institution between 1/2007 and 11/2013 was undertaken. The primary outcomes were change in BCVA and subjective patient satisfaction. Secondary outcomes included change in central macular thickness, proportion of patients with BCVA 20/20 at the post-operative year 1 visit, proportion of patients with BCVA 20/25 or better at the post-operative year 1 visit, and proportion of phakic patients that required cataract surgery.
Twenty-eight patients were included in the study. Mean preoperative BCVA was 20/40 and improved to 20/33 on post-operative month 6 and 20/29 on post operative year 1. 71% of patients reported subjective improvement in visual symptoms such as metamorphopsia and blur. 30% of patients who had completed their post-operative year 1 visit by the end of the study period had improved to 20/20, and 50% to 20/25 or better. Mean central subfield macular thickness improved from 451 µm pre-operatively to 399 µm by 1 year after surgery. 55% of phakic patients required cataract surgery within one year of vitrectomy.
In patients with good preoperative visual acuity and symptomatic epiretinal membrane, symptoms improve and there is a gradual gain in visual acuity after pars plana vitrectomy with membrane peel. In phakic patients, cataract progression necessitating cataract surgery is common.
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