Nonvitrectomizing vitreous surgery for idiopathic epiretinal membrane

This study compared the efficacy of nonvitrectomizing vitreous surgery (NVS) and pars plana vitrectomy (PPV) for idiopathic epiretinal membrane by evaluating both the central macular thickness (CMT) and disorganization of retinal inner layers (DRIL), an indicator first used for structural assessment. Medical records of 117 patients (117 eyes; NVS: 54 eyes; PPV: 63 eyes) were retrospectively analyzed. Baseline best-corrected visual acuity (BCVA), CMT, and DRIL points showed no significant intergroup differences. Postoperatively, BCVA improved, whereas CMT and DRIL points decreased greatly at 1 and 6 months in both groups. While postoperative CMT and DRIL points did not differ significantly between groups, BCVA improvement was comparable at 1 month but obviously greater in the NVS group at 6 months. Eyes with no/mild DRIL had better visual prognoses than those with severe DRIL, though marked visual improvement occurred even in cases with severe DRIL. No ERM recurrence was observed. In conclusion, NVS, which simplifies the surgical procedure and preserves the vitreous integrity, can achieve non-inferior visual functional and retinal structural outcomes compared to PPV in the treatment of iERM.