Notes: The Stoneygate Eye Hospital

Information for Patients EPI RETINAL MEMBRANE &

MACULA

EPIRETINAL MEMBRANE

The Stoneygate Overview: Eye Hospital What is epi retinal membrane and vitrectomy?

www.thestoneygateeyehospital.co.uk An is a thin sheet of fibrous tissue n the majority of cases, an epiretinal membrane develops This new technique allows for faster healing of the eye that can develop on the surface of the macular area of in an eye with no history of previous problems. This type of with minimal post-operative ocular irritation. A patch is the and cause a disturbance in vision. An epiretinal membrane is called idiopathic. Occasionally placed over the eye following surgery, and it is kept in epiretinal membrane is also sometimes called a however, an epiretinal membrane will develop in an eye as place until the next day. Eye drops or ointment are then macular pucker, premacular fibrosis, surface wrinkling a result of , trauma, inflammatory used for several weeks after surgery to facilitate healing. or cellophane . The retina is a disease, blood vessel abnormalities, or other pathological Patients can usually resume normal non-strenuous clear film of very delicate tissue that lines the inside of conditions. Most epiretinal membranes are mild and have physical activities the day after surgery. How quickly the little or no effect on vision. However, in some cases, the patient can drive, return to work, perform fine visual tasks, the back of the eye. The macula is in the center of the epiretinal membrane may slowly grow and begin to cause or engage in strenuous activities varies from person to retina and it gives us sharp central vision and reading mechanical distortion (“wrinkling”) in the macula. This person. vision. may lead to blurred or distorted vision, which may slowly worsen over time. An epiretinal membrane does not make an eye go completely blind. It typically affects only the Most patients will have a significant improvement in center area of vision and does not cause a loss of the vision after surgery, however this may occur gradually peripheral (side) vision. over several months. The amount of visual improvement varies from person to person and depends on multiple factors including the severity and Management chronicity of the epiretinal membrane, the level of Epiretinal membranes can be treated with vitrectomy vision preoperatively, and the presence of any other surgery. However, not all epiretinal membranes require ocular abnormalities. treatment. Surgery is not necessary if the epiretinal membrane is mild and having little or no effect on vision. There is no non-surgical treatment for an epiretinal Any surgical procedure carries a risk of complications and membrane. epiretinal membrane surgery is no exception. Post- operative infection () can be very serious and may lead to blindness in the affected eye. Most (Macular Pucker) Vitrectomy surgery is usually done on an outpatient basis infections can be effectively treated if identified at an early under local anaesthesia. The surgery consists of making stage. An epiretinal membrane develops as a result of cellular very small incisions on the white part of the eye (the changes that occur in the back of the eye between the ) 4 mm behind the edge of the . While looking clear vitreous gel that is normally present, and the macula. into the eye through a microscope, the surgeon can use a Endophthalmitis is rare and occurs in approximately 1 out Normal biological cells derived from the retina and other variety of specialized instruments to work within the eye. of 1000 cases. Retinal detachment is another complication tissues within the eye become liberated into the vitreous The vitreous gel is first removed and replaced with a that can cause blindness if not treated. Retinal gel and eventually settle onto the surface of the macula. specially designed saline solution. The surgeon can then detachments occur in 1 to 2 out of 100 cases following These cells may begin to proliferate into a “membrane.” In “peel” the membrane from the surface of the macula. At epiretinal membrane surgery. The progression of many instances this membrane remains very mild and the end of surgery, very fine absorbable sutures are used is a third consideration. A cataract occurs when the in does not have any significant effect on the macula or the to close the incisions. Newer surgical techniques and the eye becomes cloudy. This typically occurs with aging person's vision. In other cases, however, the membrane instrumentation may allow the surgeon to perform the but is accelerated by vitrectomy surgery. This is not a may slowly become more prominent, eventually creating surgery in some cases through tiny “self-sealing” incisions concern if the patient has already had cataract surgery a disturbance in the retina that leads to visual blurring that do not require sutures. prior to vitrectomy surgery. Other risks of surgery include and/or distortion in the affected eye. bleeding, loss of vision, double vision, scarring, a droopy , and anesthetic complications. Your surgeon will review the risks and benefits of surgery with you.