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THE ROYAL COLLEGE OF OPHTHALMOLOGISTS' NATIONAL OPHTHALMOLOGY DATABASE STUDY OF VITREORETINAL SURGERY

Report 4, Epiretinal Membrane

Jackson, Timothy L. PhD, FRCOphth*; Donachie, Paul H.J. MSc†,‡; Williamson, Tom H. MD, FRCOphth§; Sparrow, John M. DPhil, FRCOphth†,¶; Johnston, Robert L. FRCOphth†,‡

doi: 10.1097/IAE.0000000000000523
Original Study
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Purpose: To report pragmatic outcomes from a database study of epiretinal membrane surgery.

Methods: Prospective anonymized clinical audit data from electronic medical records were pooled over 10 years into a national database, from 1,131 primary epiretinal membrane operations, by 69 surgeons, in 16 U.K. vitreoretinal units.

Results: The median age of 1,131 patients was 71.6 years. A pars plana vitrectomy and epiretinal membrane peel were combined with internal limiting membrane peel in 17.0% of operations, and cataract surgery in 49.9%. Use of general anesthesia declined from 94.1% in 2001 to 28.9% in 2010. One or more intraoperative complication occurred in 9.8% (8.1% excluding cataract surgery complications). The median preoperative logarithm of the minimum angle of resolution (logMAR) visual acuity improved from 0.60 to 0.30 (Snellen 20/80–20/40) after a median follow-up of 7.0 months; 41.7% of eyes improved ≥0.30 logMAR units (approximately 2 Snellen's lines). The percentages of eyes undergoing subsequent surgery were 3.3%, 1.0%, 0.4%, and 0.8% for epiretinal membrane, retinal detachment, macular hole, and other vitreoretinal indications, respectively. Excluding pseudophakic eyes, 51.7%, 73.2%, and 76.2% of eyes underwent cataract surgery within 1 year, 2 year, and 3 years respectively.

Conclusion: These results may help vitreoretinal surgeons to benchmark their surgical outcomes, and patients to assess the risks and benefits of surgery.

This database study of 1,131 primary epiretinal membrane operations found that 41.7% of eyes improved 2 Snellen's lines, 8.1% had intraoperative complications, 1.0% developed retinal detachment, and 51.7% required cataract surgery within a year.

*School of Medicine, King's College London, London, United Kingdom;

The Royal College of Ophthalmologists, National Ophthalmology Database, London, United Kingdom;

Gloucestershire Hospitals NHS Foundation Trust, Cheltenham, United Kingdom;

§Guy's and St. Thomas, NHS Foundation Trust, London, United Kingdom; and

Bristol Eye Hospital, Bristol, United Kingdom.

Reprint requests: Timothy L. Jackson, PhD, FRCOphth, Department of Ophthalmology, King's College Hospital, London SE5 9RS, United Kingdom; e-mail: t.jackson1@nhs.net

Thrombogenics provided an unrestricted grant to fund the initial data analysis.

T. L. Jackson is a consultant to Thrombogenics and advisor to Alcon and Bausch & Lomb and DORC. P. H. J. Donachie's employer received unrestricted funding from Thrombogenics for other related projects. Thrombogenics had no data access, or any input in the study design, data analysis, or article preparation. R. L. Johnston is the Medical Director of Medisoft Limited, which developed the commercial electronic medical record from which data were extracted, for the first iteration of the National Ophthalmology Database (NOD). T. H. Williamson developed the VITREOR database, from which additional vitreoretinal data were extracted to contribute to NOD. J. M. Sparrow has no conflicting interests to disclose.

© 2015 by Ophthalmic Communications Society, Inc.