Combined vitrectomy with ILM peeling and phaco/IOL surgery for epiretinal membrane

Abstract

Abstract: : Purpose: To demonstrate excellent visual outcome and low morbidity in the performance of combined cataract and vitrectomy surgery in order to avoid the need of a second procedure for cataract extraction soon after membrane peeling. Methods: Prospective study of a series of 60 consecutive eyes operated by 1 surgeon over a 1 year period. All eyes underwent pars plana vitrectomy vitreous membrane and ILM peeling than phacoemulsification of the lens through clear cornea and foldable acrylic IOL implantation. All eyes were assessed pre and post operatively at 3 months by OCT3 radial lines to evaluate the shape of membrane and retinal thickness. Diabetic, vascular or inflammatory membranes were excluded. Results: Mean age was 73 with 31 females. Mean preoperative visual acuity was 25/100 (0,75 LogMar). Mean postoperative vision was 55/100 (0,35 LogMar) by 3 months. Macular retinal thickness measured with OCT 3 was 475 µ preoperatively and 350 µ postoperatively in the central 1000 µ area. ERM and ILM were removed in the same time in 27 eyes and separately in 33 eyes. Postoperative complications included interior chamber inflammation with synechia in 4 eyes and aggravation of cystoid macula oedema in 1 eye. Conclusion: Combined cataract and vitrectomy surgery is a safe and effective alternative in epiretinal membrane surgery. It offers faster and stable anatomical and visual improvement while avoiding the need for a second procedure.

Keywords: macula/fovea • vitreoretinal surgery • cataract