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Epiretinal Membrane and Cataract Surgery: Protecting the Macula

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Epiretinal membrane (ERM) is a thin layer of scar-like tissue on the macula that can distort the retinal surface and create subtle traction. When cataract surgery triggers an inflammatory response, ERM eyes appear more prone to macular thickening and CMO.¹

Prospective OCT studies show greater postoperative macular changes in eyes with ERM than in those with normal maculae, even after uncomplicated phacoemulsification.¹ Patients may already have reduced contrast or metamorphopsia from the membrane itself, so any superimposed oedema is particularly unwelcome.

At Blue Fin Vision® we identify ERM pre-operatively with universal OCT, discuss realistic visual expectations, and classify these eyes as higher risk for CMO.² Postoperatively we favour extended steroid–NSAID drops and careful OCT surveillance.

If the membrane is visually significant, we coordinate with vitreoretinal colleagues about the timing of potential ERM peel relative to cataract or lens replacement surgery.

References

  1. Hayashi K, Hirata A, Hayashi H. Ophthalmology. 2012;119(10):1869-1875.
  2. Ewe SY, Abell RG, Vote BJ, Liew G, Hong T. OCT detection of macular pathology in routine cataract assessment. Eye (Lond). 2015;29(9):1216-1222.

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About Blue Fin Vision®

Blue Fin Vision® is a GMC-registered, consultant-led ophthalmology clinic with CQC-regulated facilities across London, Hertfordshire, and Essex. Patient outcomes are independently audited by the National Ophthalmology Database, confirming exceptionally low complication rates.