Epi-retinal membrane

I am considering surgery for ERM. My vision is now 20/200. The other is 20/20. After reading much about post surgery complications, I am not sure if surgery is the right answer for me as I am functioning well at this point and not experiencing any change in lifestyle. However, I am told delaying surgery could cause further problems down the road. Any suggestions to help make the decision easier?
Thanks

[Michael J Kutryb, MD]

Think seriously about the surgery.  If anything ever happened to your good eye you would be very thankful for any improvement you gained in the eye with the erm.  That's the way I look at it.  In the end it is your call - if you don't feel  like having the surgery it is perfectly alright for you to go that way.  I have no problem with that.  You are in charge and it is your decision.  For my patients I have to get to know them better in order to give true personal advice.  I'm sorry I don't know you or your situation better.  Talk to your doctor and do what you think is right.

MJK-MD

[JodieJ]

I had surgery to peel an epiretinal membrane two years ago.  The surgery improved my vision in my affected eye from about 20/50 to 20/20+, although my retina will never be perfect.  There is new "sutureless" vitrectomy equipment available today which makes recovery much quicker.  Although it is considered major surgery, it is neither painful nor particularly dangerous, especially if it is performed by a skilled surgeon.  The most likely side effect is cataract formation as a result of the lens' exposure to oxygen.  But for a high myope like myself, having cataract surgery was actually a blessing in disguise.  Not only can I now find my car without correction, I can actually drive it.

I suspect that you may have a great deal to gain from retinal surgery.  My advise would be to consult more than one of the very best retinal surgeons in your area for recommendations.  (This is definitely not a procedure you would want done by a resident, fellow, or surgeon who has been practicing for only a year or two.)  

[salutz]

Thank you for your response and for sharing your experiences. I've had 2 consultations with 2 retinal specialists one in Manhattan and one on Long Island. Both felt I should have the surgery. Neither uses the "sutureless" claiming complications. Did you have the sutureless and how long after did you develop the cataract?

[JodieJ]

I had been told that the decision as to which equipment would be used would not be made until the time of my surgery.  They chose to use the older equipment which required sutures.  (I was very disappointed.)  The sutures extended the time for recovering good vision in my eye, and they were sometimes itchy.  But it's the end result that's really important.  (I've been told that most of the retinal surgeons in my area--Chicago--currently use the newer sutureless vitrectomy equipment.)

I had my surgery in January 2006.  By April of that year, I was already experiencing the early signs of a cataract--"yellowing" of vision with slight blur.  I wanted to have the cataract surgery in that year for insurance purposes, although I could have easily waited till sometime in 2007.  To be honest, I think that the cataract surgery (done in Sept. 2006) added more to my quality of life than the retinal surgery did.  I got aspheric monofocal lenses (AcrySof IQ), which give me 20/20+ distance vision in both eyes without correction.      

[salutz]

Once again thanks for your response. I have decided to have the surgery and have found a surgeon who uses the "sutureless " method and feels confident with it. So now I will just hope everything goes well.
I must agree with you that it is really necessary to get more than one opinion and learn as much as you can.

[JodieJ]

Don't worry, your surgery will be a breeze.  I had read so much about the procedure beforehand that I didn't want to miss anything.  So I begged my surgeon to let me skip the sedation, and I was actually able to watch the surgery taking place.  It was a thrilling, and hopefully, once-in-a-lifetime experience.  (Don't worry, IV sedation is standard, so you will undoubtedly sleep through it.  But there is no pain involved.)  That afternoon I went to the movies (wearing an eye patch) and stayed for a double feature.  (This is not mandatory, or even suggested, but my point is that you should be feeling all right very quickly.)  I think you can look forward to having signficantly better vision.  Best wishes.

[salutz]

I have a few more questions you may be able to answer for me. I have been reading about FILMS surgery for macular pucker. Do you know if this is the same as the sutureless. Also my sugeon says although he uses the 25 guage, he sometimes need to put in a suture at the end to close if he has reason to believe there will be a problem.
Having had the surgery, does this make sense to you.
Thank you.

[JodieJ]

My impression is that the FILMS surgery for macular pucker is rarely (never?) utilized outside the Alabama hospital where it was developed.  But it manages to get a lot of search engine hits.  It is not sutureless surgery.

What your surgeon told you makes perfect sense to me.  Best wishes for a great outcome.

[salutz]

Do you know the advantages of removing the ILM during the erm surgery? Also when having the cataract surgery in the affected eye done is the unaffectedf eye left alone or does it require a clear lens replacement. Obviously I am still researching even though my surgery date is fast approaching,
.
Thanks again

[Michael J Kutryb, MD]

I wouldn't worry about the sutureless surgery - it will really have no effect on how you do.  That depends or your eye and how well the surgery goes.  The suture or lack of one will make no difference in the end.  If you get cataract surgery in the future it will go just like every other surgery - and you will get an intraocular lens implant of the proper power for your eye.  Your other eye will either be able to be corrected with glasses, contacts, or if anisometropia is a problem - sometimes you might need cataract surgery. Probably will get glasses for a while most commonly.  Your getting ahead of yourself though.

MJK MD