Impact of Posterior Vitreous Detachment on Long-Term Functional and Morphological Retinal Status in Patients After Surgical Epiretinal Membrane Removal

Background/Objectives: Posterior vitreous detachment (PVD), which is closely related to epiretinal membrane (ERM) formation, can affect macular microstructure and function through persistent tractional forces. The aim of this study was to evaluate whether PVD status influences preoperative characteristics and long-term functional and morphological retinal outcomes after ERM surgery. Methods: Ninety patients who underwent idiopathic ERM removal were included and divided into two groups on the basis of intraoperative vitreous status: incomplete or complete PVD. Visual function, retinal imaging, microperimetry, and multifocal electroretinography (mfERG) data were assessed preoperatively and at 1, 4, and 12 months postoperatively. Results: At baseline, compared with the incomplete PVD group, the complete PVD group demonstrated greater fixation stability and lower variability, along with smaller foveal avascular zone (FAZ) areas in both superficial and deep vascular complexes. In terms of absolute postoperative values, the complete PVD group exhibited superior functional outcomes, including higher macular sensitivity and improved fixation variability parameters at 12 months. Morphologically, the incomplete PVD group showed consistently larger FAZ areas in both superficial and deep vascular complexes. In terms of changes from baseline, best-corrected visual acuity (BCVA) gain was greater in the complete PVD group at 1 and 4 months, with no difference at 12 months, whereas no significant between-group differences were observed for other functional or morphological parameters at any time point. Conclusions: Complete PVD is associated with faster visual recovery. Incomplete PVD may induce alterations at the retinal microcirculation level that persist postoperatively and influence microperimetric scores.