Visual and anatomic outcomes of epiretinal membrane surgery in highly myopic eyes with varying axial lengths

To observe the clinical features and the surgical outcomes of the high myopic (HM) patients with epiretinal membranes (ERM).

This was a retrospective study enrolled HM patients diagnosed with ERM who underwent vitrectomy between May 2012 and November 2021. Three groups were divided according to axial length (AXL): 26–<28 mm (n=43), 28–<30 mm (n=22), and ≥30 mm (n=11). Baseline characteristics and postoperative visual and anatomical outcomes were analyzed.

Totally 76 consecutive eyes of 73 HM patients (27 males), with a mean age of 60.5±9.2y (range: 38–84y) were enrolled. The initial best-corrected visual acuity (BCVA) of the three groups was not significantly different (P=0.498). Longer AXL was associated with a higher incidence of both inner and outer macular retinoschisis (MRS), ellipsoid zone (EZ) disruption, and foveal retinal detachment (all P<0.05). Only the eyes in the 26–<28 mm group showed a significant improvement in postoperative BCVA. BCVA was improved in 77.6% of the eyes. Among the eyes with BCVA not improved, 58.8% belonged to the group 26–<28 mm. The postoperative macular hole was seen in 1 (1.32%) eye. Multivariate linear regression analysis indicated that initial BCVA (P<0.001) and epiretinal proliferation (P=0.010) influenced the final BCVA.

AXL is not significantly associated with visual recovery. Early operative intervention might have better visual and anatomical outcomes in HM-ERM patients.