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What are Epiretinal Membranes?
Epiretinal membrane, also called Macular Pucker, is a thin sheet of scar tissue that develops on the surface of the macula, the area of the retina responsible for central vision. The majority of cases are mild and form in eyes with no history of previous ocular problems. As such most have little or no effect on vision. However, in some cases, the epiretinal membrane may slowly grow and begin to cause mechanical distortion (“wrinkling”) in the macula. This may lead to blurred or distorted vision, which may slowly worsen over time.
What causes Epiretinal Membranes?
The most common cause to epiretinal membrane development is aging, specifically in patients over the age of 50. In this the gel-like material that fills the back of the eye (called vitreous humor) shrinks and becomes more liquid with aging, causing it to slosh around.
Because the vitreous is attached to the retina with tiny strands of cells, it can pull on the retina as it shrinks. Sometimes, this shrinkage can release some of the retinal tissue to settle on the surface of the macula. The cells begin to proliferate forming a “membrane.”
On occasion other causes exist for membrane development including: retinal detachment, trauma, inflammatory disease, blood vessel abnormalities, or other pathological conditions
How are Epiretinal Membranes Treated?
There is no non-surgical treatment for epiretinal membranes. With that said, most epiretinal membranes are generally observed due to the mild and little effect they have on vision. However when they do become significant enough, causing vision loss, vitrectomy surgery is generally performed.
Vitrectomy surgery is usually performed on an out-patient basis and most patients receive local anesthesia. The surgery consists of making very small incisions on the white part of the eye (the sclera) 4 mm behind the edge of the cornea. While looking into the eye through a microscope, our surgeon first removes the vitreous gel and replaces it with saline solution and then “peels” the membrane from the surface of the macula. A patch is placed over the eye following surgery, and it is kept in place until the next day. Eye drops or ointment are then used for several weeks after surgery to facilitate healing.
What are the Risks to Membrane Peel Surgery?
The most common risk factor to Vitrectomy surgery is Cataract development. Cataracts can occur rather quickly after a vitrectomy, generally within the first year following surgery, but if significant can be removed once the eye has healed.
Other potential complications include:
- Eye infection (Endophthalmitis)
- Retinal detachment
- High eye pressure (Glaucoma)
- Droopy eyelid
- Double vision (Diplopia)
- Recurrence of Epiretinal membrane
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