Rate and severity of epiretinal membrane formation after scleral buckle for rhegmatogenous retinal detachment

Abstract

Purpose : To report the rate and severity of epiretinal membrane (ERM) formation after scleral buckle (SB) for rhegmatogenous retinal detachment (RRD).

Methods : A single-center, retrospective chart review of all patients who underwent SB for RRD repair between January 2015 and June 2022 and developed subsequent ERM was performed. Those who had prior ERM were excluded. Optical coherence tomography (OCT) structural analysis and ERM grading were based on a previously reported scale.

Results : 171 of 1088 eyes (15.7%) of 1088 patients who underwent SB developed subsequent ERM. 147 eyes of 147 patients were included after excluding those with prior surgery for RD. 86 (58.5%) patients were male, and 61 (41.5%) were female. The mean (SD) age was 52.9 (14.3) years. 74 (50.3%) eyes had macula-off RRD, and 73 (49.7%) had macula-on RRD. The mean (SD) logMAR visual acuity (VA) [Snellen] before SB was 0.58 (0.23) [20/76]. The mean (SD) duration between SB and ERM diagnosis was 392.2 (464.4) days. The mean (SD) logMAR VA [Snellen] at ERM diagnosis was 0.584 (0.59) [20/77]. At diagnosis, 108 (77.1%) eyes were graded as stage 1, 13 (9.3%) as stage 2, 16 (11.4%) as stage 3, and 3 (2.1%) as stage 4; 7 eyes were ungradable due to missing or poor-quality OCT images. 125 eyes (85.0%) were observed, while 22 (15.0%) underwent ERM peeling. Ten of the 22 (45.5%) eyes that had ERM peeling had ERM recurrence after peeling. The mean (SD) logMAR VA [Snellen] significantly improved from 1.21 (0.632) [20/324] before peeling to 0.671 (0.162) [20/94] at final follow-up after peeling (p=0.002). 12 (8.2%) eyes had no ERM at final visit, while 135 (91.8%) eyes had ERM. At final follow-up, 109 (83.8%) eyes were graded as stage 1, 8 (6.2%) as stage 2, 10 (7.7%) as stage 3, and 3 (2.3%) as stage 4; 5 eyes were ungradable due to missing or poor-quality OCT images. The mean (SD) logMAR VA [Snellen] at final visit was 0.458 (0.54) [20/57], which was significantly improved from VA at ERM diagnosis (p=0.002) but did not significantly differ from VA before SB (p=0.098).

Conclusions : ERM is a common complication that can develop after SB for the repair of RRD with the majority remaining fairly mild (stage 1) and managed by observation.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.