Rate and Severity of Epiretinal Membrane Formation Following Scleral Buckling Surgery

Purpose: To investigate the rate and progression of epiretinal membrane (ERM) formation following scleral buckling (SB) for rhegmatogenous retinal detachment (RRD). Methods: A retrospective review of eyes undergoing SB for RRD repair between January 2015 and June 2022 that developed ERM. ERM grading and structural analysis were performed using spectral domain optical coherence tomography (SD-OCT) based on a standardized scheme. Results: Among 1064 eyes undergoing SB, 143 eyes (13.4%) developed ERM. Over a mean (SD, standard deviation) follow-up of 5.3 (2.6) years, most eyes (122/143, 85.3%) were observed, while 21 (14.7%) underwent membrane peeling (MP) at a mean (SD) of 13.2 (13.8) months post-SB. There was no statistically significant ERM stage predilection observed in the eyes that underwent MP. The observed eyes had mean (SD) logMAR VA [Snellen equivalent] of 0.51 (0.63) [20/65] at ERM diagnosis, 0.34 (0.39) [20/44] at 12 months post-ERM diagnosis (p=0.03), and 0.36 (0.43) [20/46] at final visit (p=0.03). In eyes that underwent MP, mean (SD) logMAR VA [Snellen] improved from 1.25 (0.69) [20/356] pre-peel to 0.63 (0.71) [20/85] at final visit (p<0.001). Conclusion: ERM commonly develops after SB for RRD repair. Most cases were mild stage and managed conservatively with vision improving over 5.3 years.