Epiretinal Membrane Surgery

What is an epiretinal membrane?

An epiretinal membrane, sometimes called a macular pucker, is a thin layer of scar-like tissue that forms over the macula, the central part of the retina, and wrinkles it. As the membrane contracts, it puckers the delicate retina beneath, which distorts the central vision you use for detailed tasks. Learn more about epiretinal membranes on the NHS website.

The main symptom is distortion, so straight lines such as door frames or text can appear bent or wavy, and vision may become blurred in the centre while the side vision stays normal. Epiretinal membranes often develop with age, sometimes for no clear reason, and sometimes following another eye condition such as a retinal problem, inflammation or previous surgery. Many membranes are mild and cause few symptoms, in which case they can simply be monitored, but when the distortion or blurring begins to interfere with everyday life, surgery to remove the membrane can help. The condition is assessed with a detailed OCT scan of the retina, which shows the membrane and how much it is affecting the macula. Your consultant will explain whether your membrane is best watched or treated, based on your symptoms and the appearance of your retina.

What epiretinal membrane surgery involves

Mr Paritosh Shah performs a vitrectomy and carefully peels the membrane from the surface of the retina. Through very small openings, the vitreous gel is first removed, and then the fine membrane is gently lifted and peeled away using delicate instruments, relieving the tension that has been puckering the macula. A thin underlying layer is sometimes peeled as well to reduce the chance of the membrane returning.

The procedure is carried out in Yeovil, usually as a day case under local anaesthetic, so the eye is numbed and you stay comfortable. Because it is such precise work on a delicate structure, it is performed by a vitreoretinal specialist, and the same consultant who assesses your eye carries out the surgery and reviews you afterwards. After the operation you will use eye drops while the eye settles, and your consultant will explain what to expect during recovery. Unlike macular hole surgery, a gas bubble is often not needed, though this depends on the individual case, and any specific aftercare instructions will be made clear to you.

What to expect on the day of your surgery

Epiretinal membrane surgery benefits and considerations

Removing the membrane can reduce distortion and gradually improve vision over several months, and for many people it makes central tasks such as reading more comfortable by easing the puckering of the retina. The main aim is often to stop the distortion worsening and to recover some of the clarity that has been lost.

It is important to understand that improvement is often partial and takes time, sometimes many months, and while distortion usually lessens, vision may not return completely to how it was before the membrane formed. Your consultant will explain what is realistic for your eye. As with any retinal surgery there are risks, including the development or progression of a cataract, a rise in eye pressure, and, uncommonly, a retinal detachment or the membrane forming again, all of which are discussed with you beforehand. Because mild membranes may not need surgery at all, the decision to operate is made carefully, weighing your symptoms against the benefits and risks. Outcomes cannot be guaranteed, but surgery by an experienced vitreoretinal consultant offers the best chance of a good result. If your vision has become blurred or distorted, an assessment in Yeovil will help you understand whether treatment would help.