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Marlon J. demeritt, Ronald E. Frenkel, Max P. Frenkel; Predicting the Effect of Idiopathic Epiretinal Membranes on the Outcome of Phacoemulsification. Invest. Ophthalmol. Vis. Sci. 2011;52(14):2155.
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To attempt to determine prior to phacoemulsification surgerywhichcharacteristics of idiopathic epiretinal membranes will progress to increased macular thickness leading to a suboptimal visual outcome.
A retrospective analysis of charts of 10 patients with idiopathic epiretinal membrane or surface wrinklingretinopathy who underwent uncomplicated phacoemulsification with pcIOL and post-op treatment that included combination topical steroids and non-steroidals were analyzedStratus OCT was used pre and post-operatively to diagnose ERM and any associatedpre-existing vitreomacular traction, cystic spaces, loss of foveal depression,or intraretinalfluid. Central macular thickness(CMT) was measured.
Mean pre-op CMTfor all patients was 255 microns and post-op was 305 microns.Only 3 of the 10 patients had >= 50 micron increased (CMT) post-surgery with a mean of 103 microns thicker than pre-op, but these patients obtained a mean best corrected post-op visual acuity of 20/22. None of the patients had final acuities of <20/40. The worst patient with acuity of 20/40 had the largest increase in CMT of 145 microns.Of the 8 cases of epiretinal membrane that exhibited a post-op qualitative worsening of the foveal contour, 7 patients had pre-existing vitreomacular tractionand loss of foveal depression, and one had only loss of foveal depression but this was not related to poorer visual outcome. Pre-existing vitreomacular traction, cystic spaces, loss of foveal depression, and intraretinal fluid did not portend a poor visual outcome in this limited series.
Pre-operative quantitative and qualitative ERM characteristics did not predict which patients were likely to have poorer post-operative visual acuities in this study, but worse vision was associated with increased post-operative central macular thickness.
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