Visual Outcomes and Prognostic Factors in Epiretinal Membrane Foveoschisis and Lamellar Macular Hole Surgery: A Retrospective Study.

Purpose: To assess vision outcomes, risk of complications and whether age, gender, specific OCT changes and preoperative vision affect the prognosis for postoperative vision development. We seek to clarify the prognosis of LMH after surgery and assess whether complications can be reduced with appropriate management.

Methods: This retrospective study includes consecutive Lamellar Macular Hole (LMH) surgeries at Örebro University Hospital (2013-2019), re-evaluated using the OCT-based consensus definition. Cases were classified as Epiretinal Membrane Foveoschisis (ERM-F) or LMH. Pre- and postoperative data were collected from medical records. Statistical analyses were performed with support from medical statisticians.

Results: Both the ERM-F and LMH groups showed Highly significant visual development (p-adj = 0.0010 and 0.0012 respectively), with a median visual improvement of 90% and 38%, respectively.Even the older LMH group, in which the majority (81%) exhibited pathological OCT findings, showed a median improvement of 61% and a significant visual improvement (adjusted p = 0.026).

Conclusion: The results indicate good potential for visual improvement in both groups. Even if the LMH group experiences positive vision improvement, these patients would experience further improvement without the aforementioned OCT changes. Early surgery is highly recommended, ideally before photoreceptor damage occurs; if already present, it should be performed as soon as possible to prevent further OCT pathology.