THREE-DIMENSIONAL HEADS-UP VITRECTOMY VERSUS CONVENTIONAL MICROSCOPIC VITRECTOMY FOR PATIENTS WITH EPIRETINAL MEMBRANE

To investigate the efficacy and safety of 3D heads-up display (3D-HUD) vitrectomy compared to conventional microscopic (CM) vitrectomy in epiretinal membrane (ERM) surgery.ERM removal with or without internal limiting membrane (ILM) peeling was performed using a 3D-HUD or CM system. The mean change in best-corrected visual acuity (BCVA) and in central macular thickness (CMT) and postoperative complications were assessed.Baseline demographics were comparable except for the follow-up period. BCVA and CMT improved in both at the final visit (all p < 0.05). The ERM recurrence and dissociated optic nerve fiber layer (DONFL) rates were lower in the 3D group (both p < 0.05). CM vitrectomy (odds ratio (OR) = 12.86, p = 0.02) and absence of ILM peeling (OR = 45.25, p < 0.05) were associated with ERM recurrence. In the DONFL, CM vitrectomy (OR = 1.98, < 0.05) and combined phaco-vitrectomy (OR = 2.33, p = 0.03) were analyzed as risk factors for DONFL.The improvement in BCVA and CMT in ERM surgery using a 3D-HUD is comparable to that of CM vitrectomy, with a significantly low rate of ERM recurrence and DONFL occurrence. Therefore, 3D vitrectomy might have an advantage for ERM surgery.