ERM surgery may be equally effective in eyes with and without high myopia

Issue: August 10, 2015

Epiretinal membrane surgery in highly myopic eyes may produce satisfactory functional and anatomical outcomes comparable to those seen in non-highly myopic eyes, according to a study.

Perspective from Pravin U. Dugel, MD

The retrospective case-controlled study evaluated patients who underwent epiretinal membrane (ERM) surgery to compare the outcomes of 57 highly myopic eyes vs. 57 non-highly myopic eyes.

Mean axial length was 27.3 ± 1.1 mm in the highly myopic group and 23.1 ± 1 mm in the control group. The difference was statistically significant (P < .001)

At 1 year postoperatively, the mean improvement in best corrected visual acuity was 0.34 ± 0.22 logMAR in the study group and 0.36 ± 0.19 logMAR in the control group. Overall, 54 highly myopic eyes and 47 non-highly myopic eyes gained two or more lines of visual acuity.

Final BCVA and mean visual changes were not significantly different between the two groups. Axial length and mean improvement in BCVA were not correlated.

Central macular thickness decreased significantly in both groups, with a mean change of 102 ± 97.6 µm in the study group and 108.5 ± 68.3 µm in the control group. – by Kristie L. Kahl

Disclosure: The authors report no relevant financial disclosures.

Perspective

Pravin U. Dugel, MD

I think this was an important and interesting study. High myopia and its complications are major concerns, particularly outside the U.S., especially in Asia and Europe.
Firstly, when a patient is myopic, there is a large variability in the structure of the eye. The number of myopic complications does not necessarily correlate with the length of the eye in a linear fashion. Secondly, the scar tissue itself, the epiretinal membrane, also is quite variable. So, as interesting as this study is, it is very difficult to control all those variables. The study’s conclusion was the results of the surgery might not necessarily have much to do with the length of the eye. However, given the variables I have mentioned, I do not think this is a definitive conclusion. I think it has to be said that when someone is highly myopic, the structure of the eye will determine the success of the surgery, not necessarily the length of the eye itself. The variables are more likely to determine the success of the surgery.

Pravin U. Dugel, MD

OSN Retina/Vitreous Board Member

Disclosures: Dugel reports no relevant financial disclosures.

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Sources/Disclosures

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Source:

Conart JB, et al. Br J Ophthalmol. 2015;doi:10.1136/bjophthalmol-2014-306027.