Guan-Chyun Lin1, Huey-Shyan Lin2, Yu-Harn Horng3, Hui-Chen Chu4, Shwu-Jiuan Sheu5,6. 1. Department of Information Technology and Management, Fooyin University, Kaohsiung, Taiwan. 2. Department of Health-Business Administration, Fooyin University, Kaohsiung, Taiwan. 3. Department of Ophthalmology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan. 4. Department of Ophthalmology, Kaohsiung Medical University Hospital, No.100, Tzyou 1st Rd., Sanmin District, Kaohsiung City, 80756, Taiwan. 5. Department of Ophthalmology, Kaohsiung Medical University Hospital, No.100, Tzyou 1st Rd., Sanmin District, Kaohsiung City, 80756, Taiwan. sjiuansheu@gmail.com. 6. School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan. sjiuansheu@gmail.com.
Abstract
PURPOSE: To investigate the prognostic factors and visual outcomes for patients with epiretinal membrane after pars plana vitrectomy and possible interactions between multiple factors. METHODS: A retrospective chart review of adult patients with epiretinal membrane treated with pars plana vitrectomy performed by a single surgeon between February 1, 2015, and January 31, 2017 was conducted. The surgical procedures included standard 25-gauge vitrectomy with peeling of the epiretinal membrane and internal limiting membrane (ILM). Factors including age, sex, vision, intraocular pressure (IOP), lens status, and baseline optical coherence tomography angiography were analyzed to determine any association with visual outcomes. IOP and lens status were evaluated at every visit point and were used for analysis. RESULTS: Visual changes after pars plana vitrectomy in patients with epiretinal membrane were significantly associated with time, lens status, baseline ellipsoid zone integrity, baseline vision, baseline parafoveal vessel density of superficial capillary plexus (SPVD), and IOP. Further investigation using Johnson-Neyman analysis revealed that vision improved over time, especially in pseudophakic eyes. High IOP at baseline or during follow-up was identified as a significant factor associated with limited visual improvement. CONCLUSION: Our study showed that vision improved over time after vitrectomy for patients with epiretinal membrane. The surgical outcomes are more stable in pseudophakic eyes, and vision improved after cataract extraction in phakic eyes. IOP should be managed and monitored closely to optimize surgical and visual outcomes in patients.
PURPOSE: To investigate the prognostic factors and visual outcomes for patients with epiretinal membrane after pars plana vitrectomy and possible interactions between multiple factors. METHODS: A retrospective chart review of adult patients with epiretinal membrane treated with pars plana vitrectomy performed by a single surgeon between February 1, 2015, and January 31, 2017 was conducted. The surgical procedures included standard 25-gauge vitrectomy with peeling of the epiretinal membrane and internal limiting membrane (ILM). Factors including age, sex, vision, intraocular pressure (IOP), lens status, and baseline optical coherence tomography angiography were analyzed to determine any association with visual outcomes. IOP and lens status were evaluated at every visit point and were used for analysis. RESULTS: Visual changes after pars plana vitrectomy in patients with epiretinal membrane were significantly associated with time, lens status, baseline ellipsoid zone integrity, baseline vision, baseline parafoveal vessel density of superficial capillary plexus (SPVD), and IOP. Further investigation using Johnson-Neyman analysis revealed that vision improved over time, especially in pseudophakic eyes. High IOP at baseline or during follow-up was identified as a significant factor associated with limited visual improvement. CONCLUSION: Our study showed that vision improved over time after vitrectomy for patients with epiretinal membrane. The surgical outcomes are more stable in pseudophakic eyes, and vision improved after cataract extraction in phakic eyes. IOP should be managed and monitored closely to optimize surgical and visual outcomes in patients.