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Alexandra Sayen, Isabelle Hubert, Malicia Casillas-Gil, Karine Angioï-Duprez, Jean-Paul Berrod; Vitrectomy For Epiretinal Membrane In Eyes With A Preoperative Visual Acuity Better Than 20/40. Invest. Ophthalmol. Vis. Sci. 2011;52(14):4496.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the functional and anatomical outcomes of vitrectomy for epiretinal membrane in eyes with a preoperative VA (visual acuity) ≥ 0,3 LogMAR (20/40).
Sixty-seven of sixty-six consecutive patients that undergone surgery for an idiopathic epiretinal membrane (ERM) were studied retrospectively. A combined surgery was performed on phakic eyes (n=45). The other eyes were all pseudophakic (n=22). All patients underwent ERM and internal limiting membrane removal by using 20 (n=19) or 23-gauge (n=48) vitrectomy system between January 2002 and March 2009 by two surgeons (JPB and IH). The main studied criteria were preoperative and postoperative best corrected visual acuity(BCVA), preoperative and postoperative central macular thickness (CMT) and integrity of junction between inner and outer segments of photoreceptors (IS/OS junction) evaluated with optical coherence tomography (OCT) preoperatively and postoperatively.
The mean preoperative VA was 0.28 logMAR (range 0.15 logMAR to 0.3 logMAR). The mean VA improved to 0.19 logMAR (2 lines of vision) by the final examination at a mean of 27 months following surgery (p<0.0001). 71,6 % patients recovered visual acuity ≥ 0,1logMAR (20/25). The mean preoperative CMT was 367 µm (range 263 µm to 496 µm) and the mean postoperative CMT was 304 µm (range 198 µm to 385 µm).No correlation between postoperative BCVA and postoperative central macular thickness was noted (p=0.46).The preoperative integrity of the IS/OS line correlated with postoperative BCVA (p=0.004) but not with BCVA improvement (p=0.177). We observed one retinal detachment (1.49%), one macular hole (1.49%) and no endophthalmitis.
Vitrectomy for epiretinal membrane is a safe and effective procedure that provides VA ≥ 0,1 LogMAR in 71,6% eyes with relatively good preoperative VA ( ≥ 0,3 LogMAR). Besides the baseline VA, the integrity of the IS/OS line can be used to predict excellent functional outcomes after surgery.
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