The Safest Approach to Idiopathic Epiretinal Membrane Removal

Abstract

resulting from the proliferation of cells along the internal limiting membrane (ILM) of the macula (1, 2). The main risk factor for this condition is age. Other risk factors include trauma, ocular inflammation, and previous ocular surgery. The overall incidence in a single eye is ∼1.1% and increases to 6% in individuals aged ≥65 years (3-6). The most common symptoms associated with ERM formation are distorted vision (metamorphopsia), blurred vision, macropsia, and micropsia (7, 8). What is the traditional approach to symptomatic ErM? Traditional 20-and 23-gauge pars plana vitrectomy (PPV) with membrane peeling has been used successfully for many years to treat ERM with a postoperative morphologic and functional improvement (9-11). Nowadays, the introduction of 25-(25G) and 27-gauge (27G) PPV systems have shown superiority over traditional greater-gauge techniques, in terms of shorter surgical times, faster wound healing with less conjunctival scarring, decreased postoperative inflammation, and reduced postoperative astigmatism (12-16). Cataract extraction through phacoemulsification and subsequent intraocular lens (IOL) implantation can be performed simultaneously to PPV in presence of visually significant cataract. What are the major complications of PPV? The complication rate of PPV has been extensively reported in the current literature (17-19). Although surgical peeling represents a mainstay of ERM treatment, the frequency of peri-and postoperative complications has been globally estimated at 0.4%-0.8%. The major events are