The Problem
Epiretinal Membrane
An epiretinal membrane or scar tissue can develop over the central vision. It is more common with age and slightly more common in females. It is more common in individuals that have had previous surgery, retinal tears, previous inflammation, or retinal blood vessel problems. However, most commonly, there is no clear cause. The eye is typically otherwise healthy and has had a normal age-related change of a posterior vitreous detachment.
The theory is that cells sit down on the retina and form a sheet or scar tissue similar to saran wrap.
This is what we call an Epiretinal Membrane. This scar tissue can distort the retina and cause wrinkling of the tissue.
When an ERM forms, it can cause mild to moderate vision changes. You might notice blurriness or distortion in your vision, straight lines might appear wavy, or you might have difficulty seeing fine details.
Surgical intervention is to be considered when there is distortion of vision, such as waviness, or decreased vision.
The Procedure
Vitrectomy and Membrane Peeling
Vitrectomy is the technique for surgical removal of epiretinal membranes. It involves making three small ports in the eye. These ports are so small that they usually do not require any stitches to close as they self-seal. One port is for an infusion fluid to keep the eye pressure, while the other ports are used to introduce a light and a cutter. The light allows the surgeon to see into the inside of the eye through a microscope. The cutter is used to remove the vitreous jelly which is attached to the retina. Once the jelly is removed, small forceps and high microscope magnification are used to peel off the membrane.
Risks?
Complications of vitrectomy include: a 1 in 1,000 risk of bleeding or infection, a 1 to 2% chance of retinal tears or detachment which is fixed at the same time, although it can occur after surgery and would require a second surgery to repair. There is a high risk of cataract should one not have already had cataract surgery. Cataract surgery can always be done in the future should this occur. Cataract surgery is very safe and the most common of all performed surgeries. Sometimes the pressure can be high or low right after the surgery. If it is high, drops can be used to treat it. Low pressure usually will resolve on its own.
Overall, this is a very safe procedure. It is the most common retinal procedure performed.
Dr. Adatia will discuss with you your individual risks when consenting you for surgery.