In the video below, I discuss what is involved in an epiretinal membrane surgery. If you experience problems watching this video or wish to read the text instead, this is included under the video.
When is Epiretinal Membrane Surgery Necessary?
A small percentage of people with macular pucker or epiretinal membrane get better on their own. Sometimes, the membrane that’s growing on the surface just peels off, and when this is the case, some vision is usually recovered and most people go back to normal.
However, for most people who are symptomatic, or who notice distortion or blurring of their central vision, surgery is the best way of preventing things from worsening as well as improving quality of vision, lessening distortion, and increasing the amount you can see.
What does Epiretinal Membrane Surgery involve?
The operation for epiretinal membrane is called a vitrectomy. This is the removal of the jelly within the eye. Once the vitrectomy is done, the membrane is picked up and peeled off. I always peel the layer underneath that too, which is the surface of the macula (called the inner limiting membrane), allowing me to be sure that all the scar tissue has come off the centre of the macula.
At the end of the operation, once the vitreous has been removed and the epiretinal and inner limiting membranes are removed too, I put some steroid into the eye which causes people after the surgery to see many little black dots for around a week or so. I also insert a bubble of air to help seal the eye, and this bubble of air is often seen as a black wobbly line that gets lower and smaller with time. Usually, it is gone within five days after the surgery.
Will Vision Improve Immediately After Epiretinal Membrane Surgery?
Straight after the surgery, vision can often be much worse. I always warn people about this because they’re used to hearing friends say how fantastically they were seeing the day after cataract or laser surgery. It’s the exact opposite after an epiretinal membrane surgery, firstly because when the membrane is peeled off, it pulls on the surface of the macula, so the macula actually ends up being distorted more and doesn’t work as well. Secondly, having a bubble of air in the eye with the reflections associated with it means you may see less clearly. And thirdly, seeing the black spots from steroids can also affect your vision.
Usually, vision recovers over a matter of weeks to months. Most of the improvement in vision doesn’t really happen until at least two weeks after surgery, so it’s really important for people to understand this and be prepared for it.