Epiretinal Membrane after Cataract Surgery

1. Calvin Fong¹
2. Thomas Hong¹
3. Tania de Loryn¹
4. Paul Mitchell¹
5. Jie Jin Wang^1,2

¹Centre for Vision Research, Department of Ophthalmology and Westmead Millennium Institute, University of Sydney, Sydney, Australia
²Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia

Purpose: To perform a systematic literature review of both the prevalence and incidence of epiretinal membrane (ERM) in eyes/subjects after cataract surgery, and to compare this with rates in phakic eyes/subjects.

Methods: Literature review of population-based and clinic-based studies reporting ERM prevalence or incidence following cataract surgery.

Results: Four cross-sectional, two cohort and two retrospective studies were included, of which, five were population-based. Retinal photography was used to diagnose ERM in five studies and fundus examination in one study. Two studies did not specify the assessment method. Of three studies that specified the type of surgery, two were of phacoemulsification and one of extracapsular cataract surgery. Mean follow-up after cataract surgery, provided by four studies, was 29.4 (SD 22.9) months.

ERM prevalence in participants with previous cataract surgery ranged from 17-40%, compared to a range of 5-18% in phakic participants. The three clinic-based studies reported a post-operative incidence of 8-12% in operated eyes. A population-based cohort study reported a higher ERM incidence in participants with prior cataract surgery (9%), compared to phakic counterparts (5%), p=0.02.

Conclusions: A systematic literature review indicates a higher ERM prevalence in eyes after cataract surgery than in phakic eyes. However, the ERM prevalence in phakic eyes could be an underestimate due to presence of lens opacity in some, which caused subtle obscuration of the view. A direct comparison of ERM prevalence between surgical and non-surgical eyes in the same subjects may provide a better method to study this question.