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

Andrei-Alexandru Szigiato; Fares Antaki; Simon Javidi; Samir Touma; Renaud Duval; Ghassan Cordahi; Sebastien Olivier; Flavio A Rezende

doi:10.1186/s40942-022-00418-9

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

Int J Retina Vitreous. 2022 Sep 30;8(1):70. doi: 10.1186/s40942-022-00418-9.

Authors

Andrei-Alexandru Szigiato¹, Fares Antaki¹, Simon Javidi¹, Samir Touma¹, Renaud Duval¹, Ghassan Cordahi¹, Sebastien Olivier¹, Flavio A Rezende²

Affiliations

¹ Department of Ophthalmology, Hôpital Maisonneuve Rosemont, Montreal, Québec, Canada.
² Department of Ophthalmology, Hôpital Maisonneuve Rosemont, Montreal, Québec, Canada. frezendef@hotmail.com.

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.

Keywords: Cryotherapy; Epiretinal membrane; OCT; Optical coherence tomography; Pneumatic retinopexy; Retina; Retinal detachment; Vitrectomy.