Abstract
Purpose: :
To describe the surgical results of epiretinal membrane peel surgeries done by vitreoretinal fellows at the Massachusetts Eye and Ear Infirmary.
Methods: :
This is a retrospective review of 46 patients with epiretinal membrane (ERM) peel performed by vitreoretinal fellows at the Massachusetts Eye and Ear Infirmary between 2007 and 2011. Visual outcomes and optical coherence tomography (OCT) images acquired with Cirrus Carl Zeiss Meditec were quantitatively analyzed.
Results: :
Of the 46 patients reviewed, 26 had pars plana vitrectomy (PPV) with membrane peel (MP), 15 had PPV/MP with phacoemulsification of their cataract at the same time. In addition, 5 cases were reviewed of patients whose baseline visual acuity was compromised prior to the surgery due to retinal detachment, open globe repair or blunt trauma. Average time from surgical repair to follow up was 18 months.Of the 26 patients with PPV/MP 90% had pre-operative visual acuity of 20/40 or worse and average OCT central macula thickness (CMT) of 431. Post-operatively, 84.6% of the patient has vision of 20/40 or better, 81% gained more than 2 lines of vision, and their average CMT improved to 315, on average. Only two patients showed no improvement post operatively in their visual acuity and only one patient had worsening of his visual acuity.Of the 15 patients with PPV/MP with phacoemulsification of their cataract, all (100%) had pre-operative visual acuity of 20/40 or worse and average OCT CMT of 479. Post-operatively, 86.7% of the patient has vision of 20/40 or better, 86.7% gained more than 2 lines of vision, and their average CMT improved to 406, on average. Only one patient had worsening in his visual acuity post operatively. Of the 5 cases of poor visual acuity at baseline, 4 had history of macula-off retinal detachment repair, and one had history of trauma. All (100%) had pre-operative visual acuity of 20/40 or worse. Post-operatively, 80% of the patient has vision of 20/40 or better, 60% gained more than 2 lines of vision. Only one patient had worsening in his visual acuity post operatively and one patient had no change.
Conclusions: :
Our study shows that ERM peels performed by the vitreoretinal fellows at the Massachusetts Eye and Ear Infirmary have excellent visual and anatomical outcomes. The majority of the patients gain more than two lines of vision and show improvement in OCT CMT on follow up.
Keywords: vitreoretinal surgery • learning • macula/fovea