Clinical outcomes of epiretinal membrane surgery in patients with good baseline visual acuity

PURPOSE: For patients with symptomatic epiretinal membrane (ERM), pars plana vitrectomy (PPV) with ERM peel is often performed to improve their distortion. However, there is no clear consensus on visual acuity threshold for performing surgery, nor evidence of potential likelihood of risk to allow patients to make informed decisions. METHODS: A retrospective case notes review of visual outcomes and complications was performed at 4 UK surgical centres. All patients with symptomatic ERM and Snellen best corrected visual acuity (BCVA) of 20/40 or better (LogMAR 0.3 or better), were included. Outcome measures were BCVA at 1, 3, 6, and 12 months, as well as subjective improvement in symptoms, complications and further surgery. RESULTS: 163 eyes of 163 patients were included in analysis. For this cohort, the mean pre-operative BCVA was equivalent to the mean post-operative BCVA. 80% (n=133) maintained or improved from their baseline VA of ≤20/40, whereas 1.2% (n=2) suffered major harm with post-operative BCVA of worse than 20/200. 92% of patients reported symptomatic improvement following surgery. CONCLUSION: This study shows that for the vast majority of patients with symptomatic ERM but good visual acuity, pars plana vitrectomy and epiretinal membrane peel is a safe and successful surgery.