Intraoperative Retinal Changes May Predict Surgical Outcomes After Epiretinal Membrane Peeling

Abstract

Purpose : To investigate if intraoperative retinal changes during epiretinal membrane (ERM) peeling affect anatomic or functional outcomes after surgery.

Methods : We measured retinal thickness using an intraoperative optical coherence tomography (iOCT) device in patients undergoing pars plana vitrectomy with membrane peeling for idiopathic ERM. Changes in intraoperative central macular thickness (iCMT) were compared with postoperative improvements in CMT and best-corrected visual acuity (VA).

Results : 27 eyes from 27 patients (mean age 68 years) underwent iOCT-assisted ERM peeling surgery. Before surgery, mean VA was logMAR 0.50±0.36 (Snellen 20/63) and mean baseline CMT was 489±82 µm. Mean iCMT before peeling was 477±87 µm, which correlated well with preoperative CMT (P<0.001). Mean change in iCMT was -39.6±37μm (range -116 to +77μm). After surgery, VA improved to logMAR 0.40±0.38 (Snellen 20/50) at month 1 and logMAR 0.27±0.23 (Snellen 20/37) at month 3, while CMT decreased to 397±44μm and 396±51μm at months 1 and 3. Eyes that underwent greater amount of iCMT change (absolute value of iCMT change) were associated with greater CMT reduction at month 1 (P<0.001) and month 3 (P=0.010), while those with greater intraoperative thinning (actual iCMT change) showed a trend toward better VA outcomes at months 1 (P=0.054) and 3 (P=0.036).

Conclusions : Intraoperative changes in retinal thickness may predict anatomic and visual outcomes after idiopathic ERM peeling surgery.

This is a 2021 ARVO Annual Meeting abstract.