Clinical Ophthalmology (Mar 2020)

Long-Term Outcomes After Idiopathic Epiretinal Membrane Surgery

  • Elhusseiny AM,
  • Flynn Jr HW,
  • Smiddy WE

Journal volume & issue
Vol. Volume 14
pp. 995 – 1002

Abstract

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Abdelrahman M Elhusseiny,1,2 Harry W Flynn Jr,1 William E Smiddy1 1Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA; 2Department of Ophthalmology, Kasr Al-Ainy School of Medicine, Cairo University, Cairo, EgyptCorrespondence: William E SmiddyDepartment of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 900 NW 17 Street, Miami, FL 33136, USAEmail [email protected]: To report anatomic and logMAR best-corrected visual acuity (BCVA) outcomes with long-term follow-up after pars-plana vitrectomy and epiretinal membrane peeling (PPV-MP).Design: A retrospective case-series.Participants: Patients with epiretinal membrane (ERM) who underwent PPV-MP performed by one surgeon.Methods: Best-corrected visual acuity (BCVA) was recorded as a logMAR preoperatively and, when available, at 1, 2, 3, 5, 8, 10 years after surgery. The integrity of outer retinal layers was evaluated using spectral domain optical coherence tomography (SD-OCT).Main Outcome Measures: Postoperative BCVA at different follow-up visits and its correlation with different OCT parameters.Results: Fifty-five eyes of 49 patients were followed postoperatively with a mean of 8.6± 2.6 years (median: 9 years, range 5– 16 years). The mean BCVA improved from 0.56± 0.29 (20/72) preoperatively to 0.33± 0.25 (20/42) at 1 year, 0.29± 0.27 (20/38) at 2 years, 0.25± 0.28 (20/35) at 3 years, 0.29± 0.32 (20/38) at 5 years, 0.28± 0.31 (20/38) at 8 years, and  0.28± 0.25 (20/38) at 10 years (p< 0.001). The BCVA improved at each of the first 3 years postoperatively and remained stable at 5, 8, and 10 years. Postoperative improvement in the integrity of ELM, and EZ, on SD-OCT correlated with improved BCVA.Conclusion: BCVA continues to improve after PPV-MP during the first 3 years postoperatively and remains stable. Improved anatomic integrity of outer retinal layers correlated with improved BCVA.Keywords: idiopathic epiretinal membrane, outer retinal layer integrity, optical coherence tomography, visual outcomes

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