The impact of cataract surgery on eyes with epiretinal membranes

Abstract

Purpose : To assess the natural history of ERMs in patients undergoing cataract extraction, as well as to assess visual and anatomic outcomes of cataract surgery in eyes with an ERM

Methods : This is a consecutive case series. The study was approved by the IRB of the Miami Veterans Affairs Hospital and was a HIPAA compliant study.
Eyes with a pre-existing ERM that had undergone CE-IOL between 2010 and 2015 were identified and the charts were reviewed. Best-Corrected Snellen Visual Acuity and optical coherence tomography (OCT) characteristics at pre-op and post-op visits (1, 3, 6, and 12 months) were collected and analyzed.

Results : Fifty six eyes with a pre-existing ERM prior to CE-IOL were identified. 98% of the patients were male and the mean age was 73 ± 7.2 years. The mean post-operative BCVA was 20/30 at each follow up time-point. BCVA improved by a mean of 10 letters at 1 month (N=56; p<0.001), 11 letters at 3 months (N=37; p<0.001), 12 letters at 6 months (N=22; p<0.001), and 10 letters at 12 months (N=26; p<0.001). The mean OCT central subfoveal thickness (CST) increased by 33 μm (N=50; p<0.001), 32 μm (N=32; p=0.014), 50 μm (N=19; p=0.025), and 22 μm (N=26; p=0.089) at 1, 3, 6, and 12 months. Only one patient had ERM peel while in the study, his pre-op VA was 20/70, VA transiently worsened to 20/150, and underwent MP three months after phacoemulsification. His final VA was 20/60. The correlation coefficients between preoperative OCT central thickness and ETDRS vision improvement are -0.119 (p=0.39), -0.103 (p=0.55), 0.441(p=0.045) and 0.169 (p=0.41) at 1 month, 3 month, 6 month and 12 month respectively, which is not statistical significant except at 6 months.

Conclusions : There are few studies in the literature evaluating ERMs in the setting of phacoemulsification. In our study, BCVA can improve significantly (from 20/60 to 20/30) after cataract surgery in eyes with pre-existing ERM. Even as transient changes in central foveal thickness, average thickness and macular volume were detected up to 6 months after the initial cataract extraction, these changes did not have an impact on vision. This suggests that eyes with pre- existing ERMs are more likely to have transient CME, which does not translate into changes in vision, and which stabilized by one year. The limitations of our study included its retrospective nature, limited number of patients and only one center with a homogeneous population

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.