Combined epiretinal membrane and cataract surgery: visual outcomes

Introduction: This study compares visual outcomes between patients undergoing a single surgery combining cataract and epiretinal membrane (ERM) peel versus cataract surgery preceding ERM surgery as separate procedures.

Materials and Methods: A retrospective review was undertaken of electronic medical records for patients undergoing ERM surgery by vitrectomy, performed by a single surgeon. Peri-operative, three month, and twelve month follow-up visual data were collected. Three groups were identified: 1) Cataract surgery prior to ERM peel; 2) Combined ERM and cataract surgery; and 3) Cataract surgery post-ERM peel. Post-operative complications and mean change in visual acuity (VA) were investigated in the cataract surgery prior to ERM group compared to the combined surgery group.

Results: A total of 271 eyes underwent ERM peel either before or after cataract surgery, or combined with cataract surgery. 62 eyes were excluded as they did not have follow-up data available. Of the 209 included eyes, 62 had cataract surgery prior to ERM peel, 105 had combined ERM peel and cataract surgery, and 28 had cataract surgery post-ERM peel. Analysis of outcomes in the cataract surgery pre-ERM versus combined surgery group found improvements in both groups’ VA at three months (mean logMAR (logarithm of minimum angle of resolution) improvement -0.10 vs. -0.08, p=0.87) and twelve months post-operative follow-up (mean -0.18 vs. -0.22 p=0.54), with no significant difference between the groups. There was no difference in the proportion of eyes in either group that had peri-operative (9.5% vs. 4.8%, p=0.28) or post-operative complications (5.9% vs.1.8%, p=0.42).

Conclusion: Combined cataract and ERM vitrectomy is as effective as consecutive operations for improving VA, whilst reducing patient exposure to the risks associated with two separate procedures.