Visual outcome of surgery for epiretinal membranes with macular pseudoholes

Objective: To evaluate the effect of macular pseudohole on visual results after epiretinal membrane (ERM) surgery. Design: Retrospective case-control study. Participants: The postoperative results for 50 eyes with ERMs combined with pseudohole were compared with the results for a paired series of idiopathic ERMs without pseudohole operated on during the same period. Intervention: All patients underwent standard three-port pars plana vitrectomy, including core vitrectomy, and removal of the membrane. Main Outcome Measures: Anatomic and functional evaluations were performed before and after surgery. Main outcome measures were postoperative visual acuity and the persistence or disappearance of the pseudohole. Results: For the patients with pseudohole, median preoperative visual acuity was 20/63 (range, 20/32-20/ 860) and median postoperative visual acuity was 20/40 (range, 20/20-20/860), Vision improved by 2 or more lines in 31 (62%) of 50 eyes. Forty eyes (80%) reached visual acuity of 20/50 or more. Pseudohole persisted in 22 eyes (44%) 3 months after surgery and in 15 eyes (30%) at 6 months. There was no difference in visual acuity, whether or not the pseudohole persisted. For the patients without pseudohole, median preoperative visual acuity was 20/63 (range, 20/32-20/860). Median postoperative visual acuity was 20/40 (range, 20/20-20/860), Vision improved by 2 or more lines in 37 eyes (74%), In 36 eyes (72%), it was 20/50 or more. Neither preoperative nor postoperative visual acuity differed significantly in the groups with and without pseudohole. Conclusion: After surgery for idiopathic ERMs combined with pseudohole, visual outcome is good, and pseudohole has no adverse prognostic value. Pseudohole disappears inconstantly after surgery, but its persistence does not preclude good postoperative visual recovery.