An epiretinal membrane, also called "Macular Pucker" oder "Cellophane Maculopathy", is a thin membrane that overlies the centre of the retina, called the macula. This fibrous tissue grows on top of the inside of the central retina. Thereafter, it may contract and cause wrinkles and folds. Patients ususally notice their vision to deteriorate and may see straght lines slightly curved (metamorphopsia). This thin membrane may be visualized using a special examination technique called OCT.
In most cases, there is no obvious reason for the epiratinal membrane. IN some cases, an epiretinal membrane may follow another eye disease. Examples are a previous retinal detachment, chronic inflammatory diseases such as uveitis, retinal tears and vascular occlusions.
Should the epiretinal membrane result in compromised visual acuity or distorted vision, surgery is usually recommended. It is important to note that an epiretinal membrane is not the same as age related macular degeneration. Both deseases affect the centre of the retina, the macula, however are completely different entiyties and require different treatments. Since the epiretinal membrane can be operated, it has a better prognosis than macular degeneration.
Vitrectomy involves the removal of the vitreous body, a tranparent gel in the back of the eye which is usually liquified and plays no important role in the adult eye. Prof. Findl typically performs this surgery in local anaesthesia, nevertheless it can also be performed under general anaesthesia if the patient wishes. After removal of the gel, the epiretinal membrane is peeled using a fine forceps. Thereafter, the underlying very thin inner limiting membrane called ILM is stained with blue dye and also peeled off. Studies have shown that removal of the ILM results in better outcomes than only removal of solely removal of the epiretinal membrane. In many cases, air or gas are injected into the eye at the end of surgery. This gas bubble dissolves within a few days to weeks after surgery and is replaced by the physiological fluid produced inside the eye. In vielen Fällen wird noch Luft oder Gas als Tamponade ins Auge injiziert, welches sich dann in einigen Tagen bis Wochen von selbst auflöst und durch die eigene innere The 3 small iscisions of approximately 1mm in size are ususally self sealing, but in some cases may be secured with resolvable sutures.
Within several days after surgery vision usually improves. It may take 3-6 months until the final visual acuity is reached. Concerning the prognosis of this kind of surgery, the main goal is to preserve the visual acuity and reduce visual distortions. In many cases, visual acuity can return to nearly normal, however perfect visual acuity is reached in only few. cases. A side effect of vitrectomy is the development of a clouding of the lens, called cataract. This usually develops within several months up to few years after surgery. Cataract can be treated effectively with cataract surgery.