Our Summary

This research study looked at the relationship between changes in vision (metamorphopsia) and certain measurements of the eye in patients with a specific eye condition called epiretinal membrane (ERM). The patients had undergone a type of eye surgery called pars plana vitrectomy (PPV). The researchers measured the thickness of the central retina and a layer within the retina called the ectopic inner foveal layer (EIFL), as well as any disruptions to the outer layers of the retina before and after the surgery. They also measured the degree of vision change in different directions (vertical and horizontal) before and after the operation.

The study found that the degree of vision change before the operation was related to the thickness of the central retina and the EIFL. After the operation, the degree of vision change was still related to the thickness of these two parts of the retina. However, there was no relationship between vision change and disruptions to the outer layers of the retina.

When they analyzed all the measurements, they found out that the thickness of the EIFL after the operation was the only factor that was independently related to the degree of vision change. In other words, the thickness of this layer of the retina after the operation could predict the amount of vision change a patient might experience.

FAQs

  1. What is the relationship between vision change and the thickness of the central retina and EIFL?
  2. Is there a relationship between vision change and disruptions to the outer layers of the retina?
  3. Can the thickness of the EIFL after a pars plana vitrectomy predict the amount of vision change a patient might experience?

Doctor’s Tip

Therefore, a helpful tip a doctor might tell a patient about vitrectomy is to pay attention to any changes in vision, especially if they have undergone surgery for conditions like ERM. Monitoring the thickness of the EIFL post-surgery can help predict the extent of vision changes and guide further treatment or management. It is important to follow up with your eye doctor regularly and report any changes in vision to ensure optimal outcomes after vitrectomy.

Suitable For

Patients with epiretinal membrane (ERM) who are experiencing changes in vision (metamorphopsia) are typically recommended for vitrectomy surgery. In particular, patients with significant thickness of the central retina and ectopic inner foveal layer (EIFL) may benefit from this surgery to improve their vision. Additionally, patients who have disruptions to the outer layers of the retina may also be candidates for vitrectomy surgery to address these issues. Ultimately, the decision to recommend vitrectomy surgery will depend on the individual patient’s specific condition and symptoms.

Timeline

Overall, the timeline of a patient’s experience before and after vitrectomy surgery for ERM may look something like this:

Before surgery:

  • Patient experiences symptoms such as blurred or distorted vision, floaters, and difficulty reading
  • Patient undergoes pre-operative testing and evaluation to determine the severity of the condition and the need for surgery
  • Surgeon discusses the procedure, risks, and benefits with the patient
  • Surgery is scheduled and patient prepares for the operation

During surgery:

  • Patient undergoes vitrectomy surgery, where the vitreous gel in the eye is removed and the ERM is peeled off the retina
  • Surgery may take several hours and is typically performed under local anesthesia
  • Patient may experience some discomfort and blurred vision immediately after the surgery

After surgery:

  • Patient may experience some pain, redness, and swelling in the eye in the days following the surgery
  • Patient is instructed to use eye drops and follow post-operative care instructions to aid in healing
  • Patient may need to wear an eye patch or protective shield for a period of time
  • Patient returns for follow-up appointments to monitor healing and vision improvement
  • Vision may improve gradually over the following weeks to months as the eye heals and the retina adjusts to the surgery
  • Patient may experience some degree of vision change, which may be related to the thickness of the EIFL in the retina
  • Patient may require additional treatments or adjustments to their vision care plan to optimize their visual outcomes

Overall, the timeline before and after vitrectomy surgery for ERM involves careful evaluation, preparation, surgery, and post-operative care to achieve the best possible visual outcomes for the patient.

What to Ask Your Doctor

Some questions a patient should ask their doctor about vitrectomy for ERM include:

  1. What is the purpose of a vitrectomy for epiretinal membrane (ERM)?
  2. What are the potential risks and complications associated with vitrectomy surgery?
  3. How long is the recovery period after vitrectomy surgery?
  4. Will I need to wear an eye patch or take any medications after the surgery?
  5. How soon after the surgery will I notice improvements in my vision?
  6. Will I need any follow-up appointments or additional treatments after the surgery?
  7. How will my vision be monitored after the surgery?
  8. Are there any specific lifestyle changes or precautions I should take after the surgery to aid in my recovery?
  9. What can I expect in terms of long-term outcomes and potential vision changes after vitrectomy surgery?
  10. Are there any alternative treatments or procedures available for ERM that I should consider before deciding on vitrectomy?

Reference

Authors: Yanagida K, Wakabayashi Y, Usui Y, Umazume K, Yamamoto K, Kawakami S, Goto H. Journal: Acta Ophthalmol. 2022 Nov;100(7):775-780. doi: 10.1111/aos.15092. Epub 2022 Jan 25. PMID: 35076169