Surgical Outcomes of Epiretinal Membranes in Patients with a History of Well-Controlled Preoperative Uveitis

Abstract

To determine surgical outcomes in patients with uveitis who underwent surgery for epiretinal membrane. Multicenter, interventional, retrospective, consecutive case series. Patients with a history of controlled uveitis and concurrent visually significant epiretinal membrane. All eyes underwent 23-gauge pars plana vitrectomy with membrane and internal limiting membrane peeling between 2011 and 2015. Demographic data, visual acuity, slit lamp and fundoscopic examination, and optical coherence tomography were reviewed preoperatively and postoperatively. Visual acuity, mean central foveal thickness, macular cube volume, and uveitic activity preoperatively and postoperatively at 1, 3, and 6 months. Fifteen patients (17 eyes) were included. The mean follow-up duration was 23.2 months. Seventeen eyes (88.2%) received intravenous methylprednisolone and 10 eyes (58.8%) received intraocular steroids at the time of surgery. There was a significant improvement in mean central foveal thickness (517 vs. 371 microns; P= 0.01) and macular cube volume (12.1 vs. 9.4 mm3; P= 0.01) 6 months postoperatively. There were no epiretinal membrane recurrences. There was a trend toward improved mean postoperative visual acuity at 6 months (0.8 [±0.6] vs. 0.6 [±0.6] logarithm of the minimum angle of resolution units; P= 0.36). All eyes were inactive at the final visit, but 5 eyes (29.4%) required further immunomodulatory therapy postoperatively. One eye developed increased intraocular pressure that required topical therapy. Eyes with a history of controlled uveitis have low surgical recurrence rates that are comparable with those without uveitis. Most patients do not require escalation of immunomodulatory therapy after surgery.