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Nicholas Daniel Chinskey, gaurav shah; Epi-retinal membrane peeling in patients with good starting pre-op vision. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):5044.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the outcomes of patients undergoing removal of an epi-retinal membrane with good starting visual acuity.
All patients undergoing pars plana vitrectomy with removal of an epi-retinal membrane by a single surgeon (GS) from the years 2012 - 2014 were evaluated. Patients who were phakic, had a baseline visual acuity of 20/50 or worse and those with less than six months of follow-up were excluded from the study. Charts were retrospectively evaluated for baseline characteristics, post-operative best corrected visual acuity (BCVA), intra-operative and post operative complications.
Of the 40 patients included, only one (2.5%) developed an identifiable, serious post-operative complication related to surgery. That patient developed a vitreous hemorrhage with eventual return to baseline vision at the 3 month visit. No intra-operative complications were noted. Of the 40 patients, 19 (47.5%) had improved BCVA, 10 (25%) maintained their initial BCVA, 7 (17.5%) lost 1-2 lines and 4 (10%) lost 3 lines or greater at their last follow-up visit. Two of the four patients that lost 3 lines or greater had significant progression of dry age related macular degeneration. For most of the patients, BCVA stabilized by the 3 month visit, with few changes in future visits.
As vitrectomy becomes even safer with smaller gauge instruments, the indications for surgery continue to expand. Based on our results, surgery to remove an epi-retinal membrane is a reasonable option for those with significant metamorphopsia and highly symptomatic blurring of central vision, even with good baseline visual acuity. Complications rates were very low, 72.5% of patients either had improved or maintained their initial BCVA and half of those losing 3 or more lines had vision loss unrelated to their surgery.
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