Risk factors for epiretinal membrane formation and peeling following pars plana vitrectomy for primary rhegmatogenous retinal detachment, an OCT guided analysis

Abstract

Background To evaluate the rate and risk factors of epiretinal membrane (ERM) formation and need for ERM peeling after pars plana vitrectomy (PPV) for uncomplicated primary rhegmatogenous retinal detachment (RRD). Methods Retrospective, single-center, cohort study of 119 consecutive patients (119 eyes) that underwent RRD repair using PPV. The primary outcomes were ERM formation, classified using an optical coherence tomography grading system, and the rate of ERM peeling. Visual acuity, postoperative complications, and risk factors for ERM formation and peeling were also identified. Results Postoperative ERM formation occurred in 69 eyes (58.0%); 56 (47.1%) were stage 1, 9 (7.6%) stage 2, 3 (2.5%) stage 3, and 1 (0.8%) stage 4. Only 6 (5.0%) eyes required secondary PPV for a visually significant ERM, with a mean time to reoperation of 488 ± 351 days. Risk factors for ERM formation included intraoperative cryotherapy, more than 1000 laser shots, 360° laser photocoagulation, and choroidal detachment (p < 0.01). Eyes with more than 3 tears had a trend towards increased ERM surgery (p = 0.10). Conclusions Visually significant ERM formation following PPV for primary RRD was uncommon in this cohort (5%). Half of the ERMs were detected after the first post-operative year, indicating that this complication may be underreported in studies with only 1-year follow-up.

Incidence of Postoperative Epiretinal Membrane Development Following 23-Gauge Pars Plana Vitrectomy for Complex Diabetic Tractional Retinal Detachment: A Comparative Study of Silicone Oil and Balanced Salt Solution Tamponade

“…The study also identified several risk factors for ERM formation, including intraoperative cryotherapy, more than 1000 laser shots, 360° laser photocoagulation, and choroidal detachment [5]. The study found that visually significant ERM formation following PPV for primary RRD was uncommon in this cohort (5%) [5]. Our findings extend this understanding to the context of complex diabetic TRD, emphasizing the intricate relationship between retinal pathology, surgery, and subsequent ERM development.…”

“…According to a retrospective, single-center, cohort study of 119 consecutive patients (119 eyes) that underwent PPV for uncomplicated primary RRD, postoperative ERM formation occurred in 69 eyes (58.0%) [5]. The study also identified several risk factors for ERM formation, including intraoperative cryotherapy, more than 1000 laser shots, 360° laser photocoagulation, and choroidal detachment [5]. The study found that visually significant ERM formation following PPV for primary RRD was uncommon in this cohort (5%) [5].…”

Impact of drainage retinotomy on surgical outcomes of retinal detachment: insights from the Japan-Retinal Detachment Registry

“…A recent study indicated that half of the eyes treated by PPV for primary RRD had visible ERMs on optical coherence tomography. However, visual acuity was not impacted in the majority of these eyes, and only 5% of eyes required subsequent surgery for ERM removal 21 . Therefor, to evaluate short-term outcomes, our data evaluated the re-surgery rate and there was no significant difference between the two groups.…”

Incidence and Risk Factors of Epiretinal Membrane Formation After Pars Plana Vitrectomy for Primary Rhegmatogenous Retinal Detachment

“…These factors are presumably responsible for the differences in incidence rates. Szigiato et al [13] reported that approximately half of the ERM formation following vitrectomy was detected after the first post-operative year. The long follow-up period of our study may have affected the results.…”