Epiretinal Membrane Formation and Macular Perfusion Findings in Rhegmatogenous Retinal Detachment Treated with Vitrectomy or Scleral Buckling

Despite the abundant literature on management options for noncomplicated macula-off rhegmatogenous retinal detachment (RRD) repair, the role of the corresponding long-term postoperative macular perfusion indices and their correlation with the postoperative epiretinal membrane (ERM) formation remain vaguely understood. In this chapter, we have analyzed the incidence of postoperative ERM proliferation and the differences in the corresponding postoperative macular perfusion indices in patients who underwent two well-known surgical approaches for noncomplicated macula-off RRD. Postoperative microstructural and perfusional findings were compared, and their correlation with best-corrected visual acuity (BCVA), postoperatively, was assessed. Two study groups based on the surgical procedures performed for noncomplicated macula-off RRD were analyzed. The postoperative incidence of ERM was 23.2% and 23.63% in the buckle vitrectomy groups, respectively (p>0.05). The RRD recurrence rates in the buckle and vitrectomy groups were 8.8% and 1.82%, respectively (p>0.001). The mean BCVA values before ERM removal in the buckle and vitrectomy groups were 0.40±0.33 log of the minimum angle of resolution (logMAR) and 0.47±0.19 logMAR, respectively (p<0.05). The final mean postoperative BCVA in the buckle and vitrectomy groups were 0.43±0.14 logMAR and 0.28±0.19 logMAR, respectively (p<0.05). When the retinal perfusional indices of the buckle and vitrectomy groups were compared with the normal control group, all the perfusional indices differed significantly (p<0.01). 

Keywords: Additional surgery rate, Brilliant blue dye, Choriocapillaris flow area, Deep vascular plexus, Ellipsoid zone, Epiretinal membrane, External limiting membrane, Internal limiting membrane, Macula-off retinal detachment, Noncomplicated rhegmatogenous retinal detachment, Primary vitrectomy, Scleral buckle, Superficial vascular plexus, Vessel density.