Visual outcomes after vitrectomy for epiretinal membrane in pseudophakic eyes with a diffractive trifocal intraocular lens.

Abstract Purpose: To evaluate the effect on visual outcomes of a diffractive trifocal intraocular lens (IOL) in pars plana vitrectomy (PPV) for removal of epiretinal membrane (ERM) in pseudophakic eyes. Methods: This is retrospective case-series study on 20 eyes with a single model of trifocal IOL that underwent PPV for removal of ERM between January 2015 and September 2018 in our clinics. Follow up was at least 1 year. Primary outcome measure was mean change in visual acuity. Other outcome measures were mean change in central macular thickness (CMT), recovery of the external retinal layers, and change in spherical equivalent (SE). Results: Mean corrected distance visual acuity (CDVA) was 0.03±0.03 logMAR after phacoemulsification; this worsened to 0.23±0.10 logMAR with ERM, improving to 0.10±0.04 log MAR 12 months after PPV (p=0.001). Mean uncorrected near visual acuity (UNVA) was Jaeger 2.62±0.51 after lensectomy. This worsened to Jaeger 5.46±1.67 with ERM and improved to the initial Jaeger 2.69±0.84 after PPV (p=0.005). CMT decreased significantly, from 380.15 ±60.50 µm with the ERM to 313.70 ±36.98 µm after PPV. Mean SE after lensectomy was -0.18 ±0.38 D, which minimally changed to – 0.18±0.47 D after PPV (p=0.99). The only complication recorded after PPV was a case of cystoid macular edema. No difficulties in visualization due to IOL design were reported during PPV. Conclusion: PPV for ERM in eyes with this trifocal IOL is safe and effective, and allows recovery of the loss of UNVA.