Long-term Safety and Efficacy of Sutureless Vitrectomy for Combined Epiretinal and Internal Limiting Membrane Removal

Abstract

Purpose: The purpose of this case series is to evaluate the long-term visual outcomes of patients undergoing epiretinal membrane (ERM) removal combined with internal limiting membrane (ILM) peeling via sutureless vitrectomy. Methods: A retrospective review was conducted of 45 patients (45 eyes) with ERMs treated with 25-gauge pars plana vitrectomy (PPV) from 2010 to 2011. Data assessed included baseline characteristics, preoperative and postoperative best-corrected visual acuity (BCVA), ERM recurrence rate during follow-up, and complications arising during follow-up. Results: PPV resulted in a statistically significant improvement in BCVA (20/61 preoperatively, 20/41 1 year postoperatively, and 20/45 at the end of follow-up). Mean duration of follow-up was 66.3 months (range, 26-89). Forty-one of 45 (91%) eyes had improved or stable vision, while 4/45 (8.9%) had worse vision. ERMs recurred in 12/45 eyes (26.7%), of which 1/45 (2.2%) required reoperation. The remaining 11 recurrent ERMs were documented as visually insignificant. Mean time to ERM recurrence was 29.3 months (range, 4-72). Conclusions: In one of the longest mean follow-up studies to date, small-gauge PPV for ERM and ILM removal results in statistically significant and stable long-term visual improvement. Despite ILM removal, ERMs did recur in a substantial proportion of patients, though the vast majority were not visually significant.