Visual outcomes and complications of epiretinal membrane removal secondary to rhegmatogenous retinal detachment

Purpose: To examine visual outcomes after surgery for removal of epiretinal membrane after retinal detachment (RD) repair, and to identify possible complications. Design: Retrospective case series. Participants: Seventy-five patients who underwent surgery for removal of an epiretinal membrane after RD repair. Methods: Retrospective chart review of 75 patients who underwent surgery for removal of an epiretinal membrane after RD repair over a 10-year period. Follow-up ranged from 6 to 124 months (mean, 49). Main Outcome Measures: Measurement of final visual acuity (VA). Results: After epiretinal membrane removal, VA increased 0.43 logarithms of the minimum angle of resolution (95% confidence interval, 0.27-0.58; t = 5.47, P = 0.000). Sixty-six patients (88%) had a VA at final follow-up greater than their preoperative VA. Forty-nine patients (70%) had a final VA equal to or greater than their best VA after RD repair. Final VA of 20/60 or better was achieved in 65.3% of eyes. Of the 43 eyes that were phakic at the beginning of the study, 34 (79.1%) underwent cataract extraction before final follow-up. Five eyes (6.7%) had a recurrent RD after membrane removal. Sixteen eyes (21.3%) developed a recurrent epiretinal membrane, 1 of which (1.3% of all eyes) was visually significant, requiring repeat surgery. Conclusions: Epiretinal membrane development is a known complication of RD repair. Visual acuity can be improved in these patients by removal of the epiretinal membrane, with excellent results. In this series, recurrent membrane formation is not visually significant. Careful follow-up is needed to detect recurrent RD. (c) 2005 by the American Academy of Ophthalmology.