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How are ERMs treated?

 

If there are no symptoms and the ERM is an incidental finding on examination,  no treatment is indicated. If the epiretinal membrane is causing visual problems, surgical treatment is available.  The operation is called a vitrectomy (to remove the vitreous gel) and epiretinal membrane peel (to remove the fine membrane) which aims to improve vision.

A vitrectomy and ERM peel procedure takes approximately 45 minutes, lying flat, usually awake with the eye fully numbed. It can also be done with a mild sedative to relax or even asleep. It is usually done as a day case procedure.

Dilating and anaesthetic eye drops are put in before surgery to dilate the pupils and numb the ocular surface.  The local anaesthetic is usually given as an injection adjacent to the eye and not into the eye. The area around the eye is cleaned with an antiseptic solution and a tented cover placed over the eye and part of the face to ensure there is no infection.

An eye keyhole approach is used to insert the very fine ophthalmic surgical instruments to remove the vitreous gel (the vitrectomy) inside the eye and gain access to the retina at the back of the eye to peel off the membrane.

The epiretinal membrane is very delicately peeled off from the surface of the retina using an operating microscope to see the fine detail. After surgery, a bubble of air or gas is left inside the eye which blurs the vision for a few days. As the vision returns, there is initially some blurring and distortion which improves slowly over the next few months.

After surgery, regular eye drops are prescribed for some weeks to reduce risk infection and inflammation.

Most ERM operations are highly successful, but if the ERM is secondary to another eye problem, the surgery can take longer and the complication risk is higher. If this higher risk applies to you, the vireo-retinal surgeon will discuss this with you before and after your operation and answer any questions you may have.

 

What is the vision like after surgery for ERM?

 

Overall the vision is improved. There may be residual mild blurring or a little distortion initially, which improves over some of months and occasionally even years post-operatively, as the eye and retina recovers from the effect of having had the ERM.

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