[Functional results and complications in the long-term follow-up after 25-gauge vitrectomy of epiretinal membrane].

Background: Idiopathic epiretinal membranes can lead, among other things, to visual impairment and metamorphopsia. The treatment of choice is a pars plana vitrectomy with removal of the membrane. The improvement of visual acuity and postoperative complications have already been described in several studies.

Objective: The aim of this retrospective study is to evaluate the long-term outcome of at least 3 years.

Material And Methods: In the period from 2011 to 2016, a total of 667 eyes underwent 25-gauge pars plana vitrectomy, membranectomy and peeling of the ILM (Internal limiting membrane) because of epiretinal membrane by the same surgeon. This study included 51 eyes from 51 patients who had returned to our clinic after at least 3 years. For the follow-up, data were collected after 3 months and then annually, if available. The mean follow-up time was 57 months (37-104 months). In the postoperative follow-up visual acuity, intraocular pressure and complications were recorded.

Results: Of the 51 eyes included 34 had a 25-gauge pars plana vitrectomy with phacoemulsification and artificial lens implantation, 8 eyes without phako and 9 eyes were already pseudophakic. The most common complication in the follow-up period was a persistent macular edema with 5.9% (3 eyes) and a recurrence of epiretinal membrane in 5.9% of cases. The best corrected logMar visual acuity was 0.4 (0.1-1.3; n = 51) preoperatively, at the last examination 0.23 (0-1.0; n = 51, p < 0.001). Three months postoperatively, the logMar visual acuity was 0.29 (n = 41), after 1 year 0.25 (n = 35), 2 years 0.23 (n = 29), after 3 years 0.26 (n = 29), after 4 years 0.27 (n = 27), after 5 years 0.24 (n = 17) and after 6 years 0.24 (n = 13).

Conclusion: The 25-gauge pars plana vitrectomy is a low complication procedure for the removal of epiretinal membranes. The clearest increase in visual acuity can be seen within the first 3 months postoperatively, but then stabilizes. In the long-term follow up a change in visual acuity can also be found after more than 3 years.