Timing of Epiretinal Membrane Surgery After Uncomplicated Retinal Detachment Repair

Abstract

Purpose: To evaluate the features and outcomes of postoperative epiretinal membranes (ERMs) after retinal detachment (RD) repair based on the timing of macular peeling (MP). Methods: This retrospective consecutive case series comprised patients who had rhegmatogenous RD repair, developed an ERM, and had MP within 1 year. Results: Of the ERMs, 91% (50/55) were diagnosed between 1 month and 3 months after RD repair. When MP was performed less than 6 months after RD repair (n = 37), the final logMAR visual acuity (VA) was 0.31; this was statistically better than when MP was performed 6 months after RD repair or later (0.63, n = 18) (P = .005). In the 6-months or later MP cohort, 61% (11/18) had cataract surgery between the RD repair and MP while 7 patients were pseudophakic at RD presentation. Of the ERMs, 65%, 24%, and 11% were stage 4, stage 3, and stage 2, respectively; the final logMAR VA was 0.43, 0.38, and 0.30, respectively. There was no significant difference in the final VA or macular status between the stages. Overall, the mean logMAR VA before MP was 0.87, which improved to a final VA of 0.41 after MP (P < .001). Conclusions: ERMs formed after RD repair were most likely to be stage 4; however, this did not affect the final VA. The final VA was significantly better when MP was performed less than 6 months after RD repair. This is relevant because retina surgeons may be delaying MP until after cataract surgery.