The efficacy of different surgical methods for secondary macular epiretinal membrane

Abstract

Objective To observe the efficacy of different surgical methods for secondary macular epiretinal membrane(SEM). Methods Clinical data of 52 eyes of 52 cases with SEM who underwent surgical treatment were retrospectively analysed. Patients in group A (26 eyes) underwent pars plana vitrectomy+ membrane peeling + intravitreal injection of luncentis(0.5 mg/ 0.05 ml) .Patients in group B (26 eyes) underwent pars plana vitrectomy+ membrane peeling + fluid-air exchange + C3F8(20%) gas tamponade. Postoperative changes in best corrected visual acuity (BCVA), macular morphology and the complications were observed. Results The follow-up time was 4-14 months. In group A, the BCVA improved in 20 eyes after the operation, it was unchanged in 5 eyes and decreased in 1 eye, the post-operative BCVA improved comparing with the preoperative one (t=4.125, P=0.00035). In group B, the BCVA improved in 18 eyes after the operation, unchanged in 6 eyes and decreased in 2 eyes, the post-operative BCVA improved comparing with the preoperative one(t=3.817, P=0.00052). The difference in vision improvement between the two groups was not statistically significant(z=0.661, P=0.24). The thickness of neuroepithelium in the central macular area ( CMT) was statistically improved after the surgery in both the two groups. But the improvement of CMT was faster in group A. In group A, small amount of retinal hemorrhage happened in 6 eyes during the surgery, and vitreous hemorrhage occurred in 1 eye after the surgery. Prepheral retinal hole occurred in 3 eyes , in which one eye was cured by laser treatment, and the other two eyes needed secondary surgery. In group B, small amount of retinal hemorrhage happened in 8 eyes during the surgery, and vitreous hemorrhage occurred in 4 eyes after the surgery. Prepheral retinal hole occurred in 3 eyes, and were cured in all 3 eyes by laser treatment. Epiretinal membrane(EM)was seen in 2 eyes during follow-up time in group B, which ocurred after vitreous hemorrhage absorption. Conclusion Both the two kinds of operation can cure SEM effectively. The surgical method of group A can improve the CMT faster, reduce the risk of vitreous hemorrhage and epiretinal membrane recurrence. The surgical method of group B can cure the tractional retinal hole effectively. Key words: Macular epiretinal membrane, secondary; Surgery; Thickness, neuroepithelium, central macular area; Complications