If an epiretinal membrane (ERM) affects vision. The only way to treat it is to remove the membrane with ERM surgery. Epiretinal membrane surgery involves an operation called a vitrectomy. The jelly-like substance (the vitrous), that normally fills the centre of your eye is removed by your surgeon, using specialised instruments. The removal of the vitreous inside the eye does not cause any permanent harm, apart from speeding up the development of cataract. Your body replaces the vitreous with natural fluid that is produced inside the eye. Following the vitrectomy the surgeon can remove the membrane from the retinal surface. Epiretinal membrane surgery success is characterised by the reduction or alleviation of distortion associated with an ERM.
[British and Eire Association of Vitreoretinal Surgeons – Epiretinal Membrane, see https://beavrs.org/]
[British and Eire Association of Vitreoretinal Surgeons – Epiretinal Membrane, see https://beavrs.org/]
Your ERM surgery will usually take about an hour and is performed under local anaesthetic injection. You will remains comfortable and awake during the procedure. You will need to lie still during the procedure, especially when the membrane is being removed using fine forceps.
In some cases, the surgeon leaves a special gas bubble inside the eye which disappears on its own after a few weeks. Following membrane removal, the vision is typically more blurred initially. It can take some months for it to achieve best vision.
ERM surgery, or macular pucker surgery, is usually successful in reducing the distortion in vision due to an epiretinal membrane. Improvements in the sharpness of your vision and reading may be less predictable if you did not experience distortion prior to surgery.
Following epiretinal membrane surgery, your surgeon will give you eye drops to use for a few weeks. On some occasions, your surgeon will ask you to position your head in a certain way for a number of days. Otherwise, you can do most daily activities although you should abstain from unhygienic environments and anything that puts the eye at risk of injury.
My Eye Clinic:
Mr Habib has a special interest in macular hole surgery, epiretinal membrane (ERM) surgery, surgery for vitreous floaters, and treating complicated cataracts. Mr Habib has been a Consultant Ophthalmologist and Vitreo-retinal Surgeon at Sunderland Eye Infirmary since 2011. He is an Honorary Clinical Senior Lecturer at Newcastle University.
Kadambari Oswal is a Consultant Ophthalmic and Vitreoretinal surgeon who performs complex/high-risk cataracts and vitreoretinal surgeries including retinal detachment surgeries, macular holes, epiretinal membranes.
The risks if vitrectomy surgery to remove an epiretinal membrane include:
[British and Eire Association of Vitreoretinal Surgeons – Epiretinal Membrane, see https://beavrs.org/]
The most common side effect of ERM surgery, or macular pucker surgery, with vitrectomy is development of a cataract (cloudiness of the lens) at an earlier stage than it would have done otherwise. Rarely, cataract may occur immediately after vitrectomy surgery, but more commonly this may come on 2-3 years after the operation. You would require further surgery to treat any cataract that develops.
About 1 in 50 patients develop a retinal detachment after surgery. If a retinal detachment does develop then further surgery is required to reattach the retina. This can sometimes lead to reduced vision in the eye afterwards. The vast majority of retinal detachments are repairable, but further surgery is required, and this can be a potentially blinding complication.
This occurs very rarely, but severe bleeding within the eye can result in blindness.
This is also very rare and would be expected to occur in about 1 in 1000 patients, but if it occurs it needs further treatments and it can lead to blindness.
An increase in pressure within the eye is quite common in the days after macular hole surgery. This is usually due to the expanding gas bubble. Any pressure increase is usually short-lived and can be controlled with extra eye drops and/or tablets. If the high pressure is extreme, or becomes prolonged, there may be some potential risk to the optic nerve. In the majority, this damage does not adversely affect the vision, but some patients require long-term treatment to keep the pressure controlled.
