Your doctor will help you to decide if surgery is appropriate for you. The main reason to proceed with the operation is to attempt to correct the distortion of your central vision. If you are not aware of any visual problems, you might not need to have surgery. However, if the distortion affects your ability to work, drive, read, or perform other important activities, you should consider having an operation. Some patients decide not to have an operation and accept the distorted central vision in the affected eye. This is reasonable, especially if the vision in the other eye is not affected. There is no “right” or “wrong” decision, as every person has different needs and priorities. In general, you should only go ahead with surgery if you find the distortion of your vision troublesome at the moment, and not as a preventative measure.
The only way to treat an epiretinal membrane is by having an operation called a vitrectomy. Eye drops or glasses are not effective.
Most epiretinal membrane surgery is performed under a local anaesthetic but some are done under general anaesthetic.
During the vitrectomy, the surgeon makes tiny cuts in your eye and removes the vitreous from inside. They then grasp and gently peel away the epiretinal membrane from the retina. We usually put small stitches in the eye. These dissolve naturally over about four to six weeks. At the end of the operation, we usually put a pad and shield over your eye to protect it. These will be removed the morning after your surgery.
Your eye will feel uncomfortable, gritty, and itchy and might appear red or bruised – this is normal for 7- 14 days. Paracetamol can be taken for pain relief every four to six hours. Your eye will take two to six weeks to heal, but your vision may continue to improve for several months. You will be reviewed in clinic about two weeks after the operation. We will give you eye drops and we will explain how and when you should use them. This is to reduce any inflammation, give your eye some rest and prevent infection. Please don’t rub your eye as this may increase infection and lead to complications.
While a certain amount of discomfort is normal after the surgery, you should contact the hospital immediately if you have any of the following symptoms:
In the case of an emergency, please attend your local A&E department or Moorfields A&E, which is open 24 hours a day, seven days a week.
After an epiretinal membrane is removed, vision gradually improves over a period of three to six months in 70%-80% of patients. However, in some cases vision may not improve following surgery, due to damage already caused by the membrane. In about 10% of patients, the membrane may return, which will cause the visual problems to recur. Surgery usually improves the vision in the affected eye, but it will never be completely normal.
A vitrectomy operation can cause small tears to form in the delicate structure of the retina, which may cause the retina to move away from its normal position at the back of the eye (retinal detachment). Sometimes, the surgeon can see this problem starting during the vitrectomy operation, and will put a bubble of gas or air into your eye to prevent any damage occurring.
However, if you did experience a retinal detachment, you would need to have another (different) operation to repair the detached retina and prevent sight loss in the affected eye. There is a 1:1000 chance of total loss of vision (blind eye) and a 2-5% chance of reduced vision after this type of surgery.
If we put a gas or air bubble in your eye you must not fly for the periods of time specified below. This is because the gas or air bubble will expand in size and thus can lead to raised pressure inside your eye, leading to visual loss.
We use three types of gases:
You will be told after your surgery which type of gas bubble was used.
It is important to note that the gas can react with another gas called nitrous oxide, which can cause problems in your eye if any is administered. Nitrous oxide is commonly used during childbirth and in A&E as pain relief.
Please tell the midwife or A&E staff treating you (or ask your family to) that you have gas in your eye and that they should not administer any nitrous oxide. Should you need a general anaesthetic for any reason during this time it is important that you also tell the anaesthetist that you have had surgery and gas in your eye.
If gas is inserted into your eye during the vitrectomy operation, you may have to posture (keep your head in a certain position) after the operation while the gas bubble dissolves. During this time, your sight will be blurred. A member of staff will provide you with a posturing leaflet to assist you with this or you can view it on our website.
The likelihood of getting a cataract (where the lens in your eye becomes cloudy) increases after a vitrectomy, so you might need surgery for this condition sometime in the future.
This includes an initial consultation and a visual acuity assessment.
If further outpatient tests and investigations are required, they will be charged at an additional rate. The most commonly required test is an OCT scan. Your consultant will discuss this with you at your consultation.
The cost of onward treatment will be provided after initial consultation, based on your personalised treatment plan.
Find out more about symptoms and causes of epiretinal membrane
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