Vitrectomy for idiopathic epiretinal membrane in elderly patients: surgical outcomes and visual prognosis

Abstract

Purpose: To evaluate the clinical course and visual prognosis of elderly patients over 75 years of age who underwent PPV and peeling of idiopathic ERM.

Design: Retrospective case series.

Methods: A retrospective chart review of patients that underwent vitrectomy for idiopathic ERM in two public hospitals. Twenty nine eyes of 29 patients 75 years and older who underwent PPV and ERM peeling were included in the study series. Patients with additional ocular vision-limiting conditions other than cataract were excluded. Main outcome measures included VA improvement, OCT changes and complications.

Results: Mean patient age was 79.6 years, the highest in published literature. Mean change in VA was 0.23 logMAR units, and 65.5% patients gained 2 or more lines of vision. Eight of the 10 patients aged 80 years or older gained 2 lines or more. Fourteen patients (48.3%) achieved final VA of 20/40 or better, and only 2 (6.9%) had final VA of 20/200 or worse. Concurrent cataract extraction was performed in 73% of the phakic eyes, and at the end of the follow up 93% were pseudophakic. Complication rates were similar to those reported in the literature.

Conclusions: Pars plana vitrectomy with ERM peeling is safe and effective in restoring VA in elderly patients, and the results are comparable to those previously reported for younger patients with idiopathic ERM. Old age should not hinder surgery in patients with idiopathic ERM who seek to improve their vision and quality of life.