Surgery for epimacular membrane and vitreomacular traction syndrome

ABSTRACT

Introduction: This review on epimacular membranes (ERM) and vitreomacular traction focuses on issues concerning the surgical technique which are currently under discussion and histomorphological correlations with relevance to our current surgical approach. New developments in the field of retinal imaging and functional testing and their impact on the indication for surgery are presented and their relevance as prognostic factors is highlighted.

Areas covered: The review focuses on the current available literature and includes clinical as well as experimental trials. A literature search was performed using pubmed as a search tool.

Expert commentary: Vitrectomy for epimacular membranes has become a very effective, standardized and safe treatment. The refinement of surgical instruments and machines has greatly improved the patient´s postoperative comfort. From the patients perspective, the resolution of metamorphopsia and the improvement of contrast sensitivity as well as stabilisation of fixation and the improvement of reading visual acuity are the primary goals of treatment. Staining substances facilitate complex surgical maneuvers such as epiretinal membrane and ILM peeling. High resolution imaging and functional tests such as microperimetry contribute new insights in the pathology of tractive maculopathies and help to establish prognostic factors regarding the indication for surgery and the postoperative follow up as well.

KEYWORDS:

• Epimacular membranes
• internal limiting membrane
• macular surgery
• vital dyes
• optical coherence tomography

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Additional information

Funding

No funding to declare.