Perioperative Topical Nepafenac After Epiretinal Membrane Surgery

Epiretinal membrane (ERM) surgery generally results in favorable anatomical outcomes; however, postoperative retinal inflammation may delay visual and structural recovery. Nepafenac is a topical nonsteroidal anti-inflammatory drug with excellent intraocular penetration and may reduce postoperative inflammation.

This prospective comparative study investigates the effect of perioperative topical nepafenac on early postoperative recovery following pars plana vitrectomy with epiretinal membrane and internal limiting membrane peeling.

Participants were assigned to receive either perioperative topical nepafenac or standard postoperative treatment. The primary objective is to compare anatomical recovery, measured by optical coherence tomography, and functional recovery, assessed by best-corrected visual acuity. Secondary outcomes include changes in central macular thickness and postoperative complications.

The findings may help determine whether perioperative topical nepafenac provides additional benefit in improving early postoperative outcomes after epiretinal membrane surgery.

• Nepafenac 0.1% Ophthalmic Suspension (Drug): Topical nepafenac 0.1% administered three times daily beginning one week before surgery and continued for four weeks after surgery, in addition to standard postoperative treatment.
• Pars Plana Vitrectomy With Epiretinal Membrane and Internal Limiting Membrane Peeling (Procedure): Standard pars plana vitrectomy with epiretinal membrane and internal limiting membrane peeling performed for epiretinal membrane.

Primary outcomes

• Change in Best-Corrected Visual Acuity (BCVA) [6 months after surgery]: To compare the change in best-corrected visual acuity (logMAR) between the perioperative nepafenac group and the control group following epiretinal membrane surgery.

Secondary outcomes

• Change in Central Macular Thickness (CMT) [6 months after surgery]: To compare postoperative central macular thickness measured by spectral-domain optical coherence tomography between the two groups.
• Integrity of the Ellipsoid Zone [6 months after surgery]: To evaluate postoperative restoration of the ellipsoid zone using optical coherence tomography.
• Postoperative Complications [6 months after surgery]: To compare the incidence of postoperative complications between the two treatment groups.

Sex: All, ages: 18 Years to any

Inclusion Criteria:-

* Adults aged 18 years or older.
* Diagnosis of idiopathic epiretinal membrane requiring pars plana vitrectomy.
* Best-corrected visual acuity impairment and/or metamorphopsia attributed to epiretinal membrane.
* Ability to provide written informed consent.
* Willingness to complete the scheduled follow-up examinations for 6 months.

Exclusion Criteria:

* \- Previous vitreoretinal surgery in the study eye.
* Other retinal diseases that could affect visual or anatomical outcomes (e.g., diabetic retinopathy, retinal vein occlusion, age-related macular degeneration).
* Significant ocular trauma.
* Active ocular inflammation or infection.
* Advanced glaucoma or optic neuropathy affecting visual function.
* Media opacity preventing adequate retinal imaging.