The development of epiretinal membrane following rhegmatogenous retinal detachment repair: incidence, risk factors, and outcomes

• Published in: Arquivos brasileiros de oftalmologia Vol. 85; no. 4; pp. 370 - 376
• Main Authors: Fu, Yan, Xie, Tian-Hao, Gu, Zhao-Hui, Li, Li-Ying, Chen, Qiang, Zhang, Yue-Ling
• Format: Journal Article
• Language: English; Portuguese
• Published: Brazil Conselho Brasileiro de Oftalmologia 2021
• Subjects: Epiretinal Membrane - epidemiology; Epiretinal Membrane - surgery; Humans; Incidence; OPHTHALMOLOGY; Postoperative Complications - surgery; Retinal Detachment - epidemiology; Retinal Detachment - etiology; Retinal Detachment - surgery; Retinal Perforations - complications; Retinal Perforations - epidemiology; Retinal Perforations - surgery; Retrospective Studies; Risk Factors; Triamcinolone Acetonide; Visual Acuity; Vitrectomy - adverse effects; Membrana epirretiniana; Retinal detachment; Descolamento da retina; Epiretinal membrane; Visual acuity; Vitrectomy; Acuidade visual; Scleral buckling; Vitrectomia; Recurvamento da esclera
• ISSN: 0004-2749; 1678-2925; 1678-2925
• DOI: 10.5935/0004-2749.20220032

To investigate the incidence, risk factors, and visual outcomes of epiretinal membrane development following rhegmatogenous retinal detachment repair. This was a retrospective study of 309 eyes that underwent initial surgery for primary uncomplicated rhegmatogenous retinal detachment. Examinations were conducted preoperatively and then postoperatively at 1, 3, 6, and 12 months. The study patients were categorized into two groups depending on the presence or absence of the epiretinal membrane. The incidence of postoperative epiretinal membrane was 28.5%; 42.7% of these patients had severe epiretinal membrane development and therefore underwent the epiretinal membrane removal. Logistic regression analyses revealed that giant retinal tears (OR: 2.66; 95% CI: 1.045-6.792, p=0.040) and horseshoe tears (OR: 0.534; 95% CI: 0.295-0.967, p=0.039) were the significant predictors of postoperative epiretinal membrane. Triamcinolone acetonide staining was significantly associated with the prevention of epiretinal membrane (p=0.022). A total of 34 patients showed a better or an equal final best-corrected visual acuity; of which 4 eyes were evaluated at the final follow-up visit and exhibited a reduced best-corrected visual acuity. Our analysis demonstrated that horseshoe tears and giant retinal tears represent the risk factors for the postoperative epiretinal membrane. Triamcinolone acetonide staining had a significant preventive effect on the postoperative epiretinal membrane. Furthermore, a second round of pars plana vitrectomy, including membrane removal, led to a significant improvement in the final best-corrected visual acuity as per the last follow-up examination, albeit the recovery was limited.