Abstract
Purpose: :
To evaluate indications, complications, and visual acuity (VA) outcomes of 25–gauge sutureless vitrectomy for epiretinal membrane (ERM).
Methods: :
Single–center, consecutive case series of 27 patients (28 eyes) undergoing 25–gauge vitrectomy, by one of the authors, at Bascom Palmer Eye Institute between December 2004 and October 2005.
Results: :
The causes of ERM in this series were diabetic retinopathy (13 eyes), idiopathic (11 eyes), previous retinal detachment repair (4 eyes), and CRVO (1 eye). The average follow–up period was 12 weeks. The lens status was pseudophakic (14), phakic (13), and aphakic (1). The average preoperative intraocular pressure (IOP) was 15 mmHg (range 8 to 32 mmHg), and was 12 mmHg postoperatively on the first day (range 4 to 27 mmHg), and 15 mmHg at last follow–up (range 7 to 24mmHg).The average OCT central macular thickness was 497 microns (range 332 to 665) preoperatively, and was 277 microns (range 168 to 399) postoperatively. None of the cases were converted to 20–Gauge. Post operative complications encountered included persistent macular edema (5 eyes), progression of cataract (5 eyes), recurrent ERM (4 eyes), elevated IOP (27 mmHg in one eye), postoperative vitreous hemorrhage (1 eye), and retinal detachment ( 1 eye). No filtering conjunctival blebs were noted. The preoperative VA was ≥ 20/60 (7 eyes), between 20/70 and 20/200 (14 eyes), and ≤ 20/300 (7 eyes). The postoperative VA was ≥ 20/60 (10 eyes), between 20/70 and 20/200 (11 eyes), and ≤ 20/300 (7 eyes). From the baseline to the last examination, 10 eyes (36%) had ≥ 2 lines improved VA, 12 eyes (43%) had +/– 1 line (unchanged), and 6 eyes (21%) had ≤ 2 lines VA (worse).
Conclusions: :
ERM of various etiologies may be successfully managed with 25–gauge transconjunctival vitrectomy. While OCT measurements greatly improved during the postoperative course, VA results were only modestly improved at the mean 12 weeks follow–up time.
Keywords: vitreoretinal surgery • macula/fovea • visual acuity