Clinical Ophthalmology (Jul 2019)
Idiopathic epiretinal membrane surgery: safety, efficacy and patient related outcomes
Abstract
Lorenzo Iuliano,1 Giovanni Fogliato,1 Francesca Gorgoni,2 Eleonora Corbelli,1 Francesco Bandello,1 Marco Codenotti11Ospedale San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy; 2Ospedali Riuniti di Ancona, Università Politecnica Delle Marche, Ancona, ItalyAbstract: This review aims to give to the reader an overview selectively oriented on safety and efficacy of surgery, providing concise and direct answers about crucial questions of trainees and experts. Surgery for idiopathic epiretinal membrane (ERM) is a safe and effective procedure that can achieve long-term stable postoperative visual and anatomical improvement, with an overall low recurrence and complication rate. Young patients, with a short onset of symptoms and with better initial visual acuity achieve higher levels of visual outcome. The preoperative degree of metamorphopsia is the prognostic factor for their postoperative degree. Successful results may be obtained in eyes with specific optical coherence tomography criteria, such as thin ganglion cell layers, thin internal plexiform layer, longer photoreceptors outer segment, regular ellipsoid zone and cone outer segment tips line, and without ectopic inner foveal layer. Internal limiting membrane peeling demonstrates positive anatomical and functional outcomes, but final positions about its safety remain controversial.Keywords: idiopathic epiretinal membrane, outcome, safety, efficacy, prognostic factor
