Risk Factors, Onset, and Progression of Epiretinal Membrane after 25-Gauge Pars Plana Vitrectomy for Rhegmatogenous Retinal Detachment

Purpose: To investigate the risk factors, onset timing, and progression of epiretinal membrane (ERM) after pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RRD). Design: Retrospective, comparative case series. Participants: The study included 322 eyes of 322 patients who underwent primary PPV for RRD from January 2014 through December 2016. Methods: Patients underwent OCT before and 1, 3, 6, and 12 months after surgery. Patients showing hyperreflective lines above the inner retinal surface and deformation of the foveal pit were defined as ERM cases. Those with loss of the foveal pit were defined as advanced ERM cases. A multivariate logistic regression model was used to evaluate the risk factors of postoperative ERM. The onset timing of ERM and progression to advanced ERM after PPV for RRD were also investigated based on the OCT findings. Main Outcome Measures: Risk factors, onset timing, and progression of ERM after PPV for RRD. Results: In the multivariate analysis, the incidence of postoperative ERM was significantly higher in eyes with preoperative vitreous hemorrhage (VH; P = 0.011) and without internal limiting membrane (ILM) peeling (P < 0.001). Among the patients who underwent ILM peeling, none demonstrated postoperative ERM. Postoperative ERM was observed in 39 of the 322 eyes (12.1%) within 1 year after surgery; in 30 of these eyes (76.9%), ERM occurred within 3 months after surgery. Advanced ERM was observed in 12 eyes (12/39 eyes [30.8%]). Among these, 9 eyes (9/12 eyes [75%]) showed progression within 3 months after surgery. Conclusions: Preoperative VH can increase the occurrence of postoperative ERM. In most patients with ERM, the occurrence and progression were detected relatively early after surgery; therefore, in high-risk patients, careful follow-up is encouraged until 3 months after surgery. (C) 2019 by the American Academy of Ophthalmology