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Purpose  To assess the rate of occurrence and the risk factors of postsurgical macular edema (PSME) in eyes with idiopathic epiretinal membrane (iERM) or full-thickness macular hole (FTMH).    Methods  Retrospective longitudinal analysis of all subjects scheduled for vitrectomy with or without combined cataract surgery over a 6-month period. Electronic medical charts and imaging data were analyzed preoperatively and at 1, 3 and 6 months after surgery.    Results  From 101 patients diagnosed with iERM or FTMH, 71 patients were eligible for the study. Forty-nine eyes with iERM (69.0%) and 22 eyes with FTMH (31.0%) underwent vitrectomy either isolated (31.0%) or combined with cataract extraction (69.0%). The overall rate of PSME was 26.7%, without differences between the two groups ( P  = 0.9479). Combined cataract extraction did not affect the overall occurrence of PSME rate in both groups ( P  = 0.9255 in FTMH and  P  = 0.8658 in iERM). If grouped by stage, eyes with stage 4 iERM though disclosed an increased rate of PSME (57.1%) compared to lower (1 to 3) stages (14.3%,  P  = 0.0021), particularly when combined with cataract surgery (71.4% vs. 15.4% in stages ≤ 3,  P  = 0.0021). The PSME odds ratio for a stage 4 iERM is 8 (95% CI: 1.933–33.1;  P  = 0.0041) compared to stages 3 and below.    Conclusions  PSME remains a clinically relevant and frequent event after surgery for iERM and FTMH. Patients with stage 4 iERM have an 8-fold higher likelihood of developing PSME in a 6-month postsurgical period compared to iERM in 1–3 stages, especially when combined with cataract extraction.

Increased risk of postsurgical macular edema in high stage idiopathic epiretinal membranes