Anatomical and Functional Factors Influencing Recovery in Idiopathic Epiretinal Membrane After Surgery

Abstract Purpose We aimed to explore the anatomical and functional factors influencing recovery outcomes in patients with idiopathic epiretinal membranes (iERM) after surgical intervention. Methods Participants diagnosed with iERM underwent pars plana vitrectomy with ERM and internal limiting membrane (ILM) peeling. ERM staging, preoperative and postoperative findings of retinal microstructures, and thickness changes using optic coherence tomography, and inner and outer retinal layer thickness changes preoperatively and postoperatively were analyzed. Results The study analyzed 85 eyes from 65 patients (mean age, 65.64 ± 6.19 years) with idiopathic ERM who underwent PPV and both ERM and ILM peeling without recurrence within one year. Male accounted for 44.71% (38/85). The mean preoperative vision was 0.47 [Snellen equivalent (SE), 68/200] ± 0.29 logMAR, and the mean final vision was 0.32 (SE, 96/200) ± 0.30 logMAR. Visual improvements were significant ( p < 0.001, paired t -test). Preoperative lens status, preoperative vision, preoperative inner and outer segment junction (IS/OS) distortion, final lens status, and follow-up duration significantly correlated with final vision. Central foveal thickness, inner and outer retinal layer thickness decreased continuously until 12 months postoperatively in the pseudophakia group, whereas for those in the phakia group, the outer retinal layer thickness decreased only in the first 6 months. Conclusions Phakia, poor initial vision, IS/OS distortion, and short follow-up do worsen the final visual outcomes. The postoperative central foveal thickness, inner and outer retinal layers thickness showed the longest statistical improvement in pseudophakic eyes over 12 months.