RESUMEN
To investigate the long-term effect of unilateral idiopathic epiretinal membrane (uiERM) removal on monocular and binocular visual function, and on vision-related quality of life (VR-QoL). Prospective, single-center study. The following data were collected before and after surgery: distance monocular and binocular best-corrected visual acuity (BCVA), horizontal and vertical metamorphopsia, horizontal and vertical aniseikonia, stereoacuity and National Eye Institute Visual Function Questionnaire-25 item (NEI VFQ-25). Forty-two patients (mean age: 72.7 ± 7.4 years; 24 men) were included. At 6 months postoperatively, distance monocular BCVA (p < 0.001), horizontal metamorphopsia (p = 0.001) and the composite score of NEI VFQ-25 (p < 0.001) significantly improved, in comparison to baseline. At 2 years postoperatively, distance monocular (p < 0.001) and binocular (p = 0.01) BCVA, horizontal (p < 0.001) and vertical (p = 0.02) metamorphopsia, vertical aniseikonia (p = 0.01), stereoacuity (p < 0.001) and 3 subscales scores of the NEI VFQ-25 (p < 0.05) ("general vision", "mental health", "driving") significantly improved in comparison to baseline. Removal of uiERM improves VR-QoL and achieves good visual outcomes on both monocular and binocular visual parameters over long-term. Visual symptoms induced by macular contraction have different improvement kinetics after surgery. Stereopsis, the highest level of binocular vision, can be improved in some cases.
Asunto(s)
Membrana Epirretinal/fisiopatología , Membrana Epirretinal/cirugía , Calidad de Vida , Visión Binocular/fisiología , Visión Monocular/fisiología , Agudeza Visual/fisiología , Vitrectomía , Anciano , Membrana Epirretinal/psicología , Femenino , Humanos , Masculino , Estudios Prospectivos , Encuestas y Cuestionarios , Factores de Tiempo , Resultado del TratamientoRESUMEN
OBJECTIVE: To study the effect of surgical treatment on quality of life (QOL) in patients with epiretinal membrane (EM). MATERIAL AND METHODS: A total of 48 patients who underwent surgical treatment for EM were examined. QOL was assessed with the VFQ-25 questionnaire before and after the surgery (at 1 week and 6 months). RESULTS: Before the surgery the total QOL index was significantly decreased by an average of 25% as compared with the controls (p<0.001). In the late postoperative period there was a progressive increase in the total index of QOL up to the level of the control group (p>0.05). CONCLUSION: Vitrectomy surgery improves visual functions and quality of life in patients with epiretinal membrane.
Asunto(s)
Membrana Epirretinal/cirugía , Calidad de Vida , Vitrectomía/métodos , Adulto , Anciano , Membrana Epirretinal/psicología , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios , Factores de Tiempo , Resultado del TratamientoRESUMEN
BACKGROUND: Although macular pucker removal in patients with metamorphopsia due to a macular pucker is a traditional elective vitreoretinal indication, we found that patients were not uniformly satisfied after surgery. We wished to study outcome in vision and metamorphopsia in patients undergoing macular pucker surgery, to assess changes between 1- and 5-year follow-up, as well as patient satisfaction at 5 years. METHODS: We assessed 107 consecutive patients undergoing macular pucker surgery and subsequent cataract surgery when not already pseudophakic. Early Treatment of Diabetes Study (EDTRS) vision and Sine Amsler Chart metamorphopsia grading were assessed before surgery and 1 year postop in 107 patients. In 57 patients we obtained a 5-year vision, metamorphopsia grading and a response to a questionnaire. RESULTS: After 1 year, mean vision had improved 2 ETDRS lines and metamorphopsia had decreased in 83% of the patients. The 57 patients returning for the 5-year follow-up and questionnaire had a statistically significantly greater improvement in vision at 1 year than those who did not return. In these 57 patients, a further mean increase of 1 ETDRS line had occurred, as well as a further decrease in metamorphopsia in one third of the patients. Forty of 57 patients (70%) indicated that they would elect to have surgery again. Reasons for not returning after 5 years, however, were probably related to dissatisfaction in at least one third of patients. CONCLUSIONS: Although macular pucker surgery resulted in an increase in vision and a decrease of metamorphopsia in 83% of patients after 1 year, we assume, based on the biased patient sample we questioned after 5 years, that subjective assessment would be positive in only a small majority of the patients.