Aims/Background-This study was performed to identify factors predictiv
e for recurrence of idiopathic and secondary epiretinal membranes afte
r vitrectomy. Long term visual outcome was determined and compared wit
h eyes without recurrence of epiretinal tissue. Methods-Out of 350 con
secutive cases vitrectomised for removal of epiretinal macular membran
es, 42 patients (42 eyes) with recurrence of epiretinal membranes were
re-examined and their records reviewed. Recurrence of epiretinal memb
ranes was determined by new appearance of epiretinal tissue or abnorma
l sheen of the central retina. The preoperative findings, best postope
rative and final visual acuity of these patients were compared with a
comparable cohort of eyes without recurrence after removal of macular
pucker (131 eyes). The eligibility criterion was a follow up of at lea
st 6 months. Results-The best postoperative (0 . 46 (SD 0 . 24)) and t
he final visual acuity (0 . 39 (0 . 26)) of eyes with recurrent membra
nes (42 eyes) was statistically better than preoperative vision (0 . 2
7 (0 . 22)) (p = 0 . 0003 and 0 . 0089). Because of reduced or distort
ed vision eight of the 42 eyes underwent a revitrectomy during the fol
low up (mean 23 months). Best postoperative visual acuity (0 . 50 (0 .
21)) and final visual acuity (0 . 47 (0 . 25)) of eyes which received
a second vitrectomy (n = 8) were not statistically different from the
32 eyes with recurrence of epiretinal tissue but without revitrectomy
(p = 0 . 253 and 0 . 343). In addition, eyes with recurrence showed n
o different visual outcome compared with eyes without recurrence of ep
iretinal membranes after vitrectomy (p = 0 . 84). Recurrence of epiret
inal membranes was correlated with neither the type of membrane (thick
or thin) nor incomplete membrane removal during pars plana vitrectomy
. Conclusion-This study demonstrates the overall favourable visual pro
gnosis of patients with vitrectomy for macular pucker, even with recur
rence of the premacular membrane.