Evaluation of New and Preexisting Epiretinal Membranes Following Glaucoma Filtration Surgery

Ryota Aoki; Saki Dote; Satomi Oogi; Yuki Nagata; Kanae Ueda; Etsuko Terao; Shunsuke Nakakura

doi:10.7759/cureus.46441

Evaluation of New and Preexisting Epiretinal Membranes Following Glaucoma Filtration Surgery

Cureus. 2023 Oct 3;15(10):e46441. doi: 10.7759/cureus.46441. eCollection 2023 Oct.

Authors

Ryota Aoki¹, Saki Dote¹, Satomi Oogi¹, Yuki Nagata¹, Kanae Ueda¹, Etsuko Terao¹, Shunsuke Nakakura¹

Affiliation

¹ Ophthalmology, Saneikai Tsukazaki Hospital, Himeji, JPN.

Abstract

Secondary epiretinal membranes (ERMs) can develop from various causes, including those associated with glaucoma treatments such as trabeculectomy (TLE) and EX-PRESS (EXP) insertion surgery. This study aimed to investigate the occurrence of new ERMs and changes in preexisting ERMs following TLE or EXP insertion. Between April 2018 and March 2019, 102 and 74 eyes that underwent primary and standalone TLE and EXP insertion, respectively, were evaluated. Of these, 48 eyes were included in the TLE group and 32 eyes were included in the EXP group. Optical coherence tomography (OCT) was used to assess preoperative and postoperative ERMs. In the TLE group, postoperative ERMs were observed in one (case 1) (3%) out of 34 eyes without preexisting ERMs and in one (case 2) (7%) out of 14 eyes with preexisting ERMs, showing an increase in ERM stage. In the EXP group, postoperative ERMs were observed in one (case 3) (5%) out of 22 eyes without preexisting ERMs and in one (case 4) (10%) out of 10 eyes with preexisting ERMs, showing a decrease in the ERM stage. Case 1 was a 58-year-old man with primary open-angle glaucoma (POAG) in the left eye who underwent TLE. Although no preoperative ERMs were observed, postoperative ERM was noted at the three-month follow-up. Case 2 was a 49-year-old man with POAG in the right eye who underwent TLE. Although ERM was observed preoperatively, ERM progressed at six months postoperatively. Case 3 was a 59-year-old woman with POAG in the right eye who underwent EXP insertion. No preoperative ERMs were observed, but an ERM was noted at the 15-month follow-up. Case 4 was a 72-year-old woman with steroid-induced glaucoma in the right eye who underwent EXP insertion surgery. A preoperative ERM was present, and the foveal pit was absent; however, the foveal pit was observed at the 12-month follow-up. Despite the low incidence of ERMs, filtration surgery may be associated with ERM development and the progression or regression of preexisting ERMs.

Keywords: ex-press; filtration surgery; glaucoma; secondary epiretinal membranes; trabeculectomy.