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S. Sakimoto, Y. Saito, T. Fujino, K. Nakata, N. Hamanaka, Y. Sakamoto, M. Tatebayashi, K. Nakae; Visual Outcomes After Peeling of Secondary Epiretinal Membranes Following Pars Plana Vitrectomy. Invest. Ophthalmol. Vis. Sci. 2007;48(13):4131.
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Several studies have reported visual improvement after removal of epiretinal membranes (ERMs) following retinal detachment (RD) repair, but the results after pars plana vitrectomy (PPV) for various diseases have not yet been studied extensively. We evaluated visual outcomes after excision of secondary ERMs after PPV and identified possible complications of the procedure.
We retrospectively reviewed 40 patients who underwent secondary surgery to remove postoperative ERMs over a 7-year period after PPV for RD (31 eyes), proliferative diabetic retinopathy (PDR) (7 eyes), acute retinal necrosis (1 eye), and retinal macroaneurysm (1 eye). We evaluated possible predictors of changes in visual acuity (VA) after ERM surgery: age at ERM removal, eye affected, gender, macular status, disease treated by previous PPV, time from previous PPV to ERM removal, internal limiting membrane peeling, and use of 20- or 25-gauge vitrectomy system. Follow-up periods ranged from 13 to 90 months (mean, 40.9).
After ERM removal, the final VA improved 0.51 logarithms of the minimum angle of resolution (P=0.000). Thirty-three patients (82.5%) had VA improvement greater than 2 lines at the final follow-up. The average period for VA improvement greater than 2 lines was 2.03 months. A final VA of 20/60 or better was achieved in 57.5% of eyes. Only patient age at ERM removal was a significant predictor of VA improvement (P=0.03). There was no significant difference in VA improvement between prior surgeries for RD and for PDR. Thirty-eight eyes (95%) had already undergone cataract extraction before ERM surgery. Two eyes (5%) had a recurrent RD after ERM removal.
ERM development is a complication of PPV. The VA can improve in these patients by removing the ERM with excellent results. In this series, there was no significant difference in VA improvement between prior surgeries for RD and for PDR. Careful follow-up is needed to detect recurrent RD.
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