Surgery for ERMs (Epiretinal Membranes)

Treatment and prognosis

Since most ERMs are fairly stable after an initial period of growth, they can simply be monitored as long as they are not affecting vision significantly. In rare circumstances, the membrane will spontaneously release from the retina, relieving the traction and clearing up the vision. However, if an exam shows progression and/or functional worsening in vision, surgical intervention may be recommended.

There are no eye drops, medications or nutritional supplements to treat ERMs. A surgical procedure called vitrectomy is the only option in eyes that require treatment. With vitrectomy, small incisions are placed in the white part of the eye, and the vitreous gel filling the inside of the eye is replaced with saline. This allows access to the surface of the retina where the ERM can be removed with delicate forceps, thereby allowing the macula to relax and become less wrinkled. 

The risk of complications with vitrectomy is small, with about 1 in 100 patients developing retinal detachment and 1 in 2000 developing infection after surgery. Patients who still have their natural lens will develop increased progression of a cataract in the surgical eye following surgery.

Factors affecting visual outcome include:

• Length of time the ERM has been present
• The degree of traction (or pulling)
• The cause of the ERM (Idiopathic ERMs have a better prognosis than eyes with prior retinal detachment or retinal vascular diseases

Surgery for ERM has a good success rate, and most patients experience improved visual acuity and decreased metamorphopsia following vitrectomy.