Management of idiopathic epiretinal membrane (iERM) combined phacovitrectomy versus a 2‐step sequential surgery

Abstract

Reported prevalence of (iERM) is more than 34% in the over 60 years old, increasing with age. A respectful number of patients require surgical management to avoid further deterioration in their distance visual acuity, binocular function, metamorphopsia and anisekonia, it has been reported that vitrectomy for ERM removal accounts approximately 10% of the procedures in vitreo‐retinal units. In this age group where an iERM is present the prevalence of cataract is high. A dilemma appears in phakic presbyopic eyes with iERM whether to do combined phacovitrectomy or a 2‐step sequential surgery. Phacovitrectomy has been proven a safe procedure with non‐inferior anatomical and functional post‐operative results. Sequential surgery (cataract first)maybe preferable because visual acuity results after removal of cataract maybe sufficient for patients' satisfaction and no necessity for further surgical management maybe the case for up to 17% of patients originally listed for two procedures. Sequential surgery (vitrectomy first) may have advantages for better prediction in final refraction after the cataract removal, the percentage of post‐vitrectomy cataract complications may arise. Individualization for the procedure of choice (Sequential or Phaco‐vitrectomy) for combined Cataract and iERM will be discussed during the presentation of SIS.