Epiretinal membrane (ERM) surgery is a keyhole vitrectomy that removes a sheet of scar tissue from the surface of the macula. Also called macular pucker or cellophane maculopathy, an ERM contracts over time and wrinkles the central retina, causing blurred and distorted vision. The surgeon removes the vitreous gel and gently peels the membrane (usually with the underlying internal limiting membrane) to let the macula flatten. Around 75–80% of patients gain clearer, less distorted vision over the following months. Private self-pay fees start from £6,500 per eye, all-inclusive of consultant, theatre and follow-up.
What is an epiretinal membrane?
An epiretinal membrane is a fine, semi-transparent layer of cells that grows across the surface of the macula — the central part of the retina that gives you sharp, detailed vision. As the membrane matures it contracts and shrinks, dragging the delicate retina underneath into folds and wrinkles. This is why it is also known as a “macular pucker”.
Most epiretinal membranes are idiopathic and age-related, developing after the vitreous gel separates from the retina (posterior vitreous detachment). They can also follow a retinal tear, previous eye surgery, inflammation or diabetic eye disease. ERM is closely related to macular hole and vitreomacular traction. Read more on our epiretinal membrane condition page.
Symptoms of an epiretinal membrane
- Distorted central vision — straight lines look bent or wavy (metamorphopsia)
- Blurred reading vision and difficulty with fine detail
- A central “haze” or greyness over the middle of the view
- Objects appearing a different size in the affected eye
- Often mild and slowly progressive; side vision is unaffected
Wavy or warped central vision? An OCT scan images the membrane and measures how much it is distorting the macula — the key to deciding whether surgery will help.
Book a macular assessmentTreatment options
Not every epiretinal membrane needs surgery. Mild membranes that cause little distortion are simply monitored. Surgery is recommended when symptoms affect daily life or the OCT shows progressive wrinkling.
All membrane peels are carried out by our vitreoretinal surgery team, who also manage related conditions such as macular holes and vitreous haemorrhage.
What happens during surgery
Epiretinal membrane surgery is a day-case keyhole vitrectomy under local or general anaesthetic, usually taking 45–60 minutes:
- Anaesthetic is given and three tiny ports are made in the white of the eye (pars plana).
- A vitrectomy removes the vitreous gel to give the surgeon clear access to the macula.
- Using fine forceps and a contrast dye, the surgeon peels the membrane — usually with the underlying internal limiting membrane — off the macular surface.
- The retina is checked for tears, which are treated if found. A gas bubble is not usually needed.
- The ports are closed and the eye is shielded. You go home the same day.
Recovery week-by-week
Recovery is gentler than gas-based surgery because most ERM peels do not need a bubble or posturing. Vision improves slowly as the macula relaxes.
First few days
The eye is gritty and a little red. Use prescribed drops. Most people are comfortable with simple painkillers and can read with the other eye.
Weeks 1–2
First review and OCT confirm the membrane is removed and the macula is starting to flatten. Light activities resume.
Weeks 2–8
Distortion begins to settle and central vision sharpens gradually. A cataract may develop or progress and can be treated later.
Months 3–6
Vision continues to improve for up to 6–12 months. Most patients see clearer, straighter images, though some residual distortion can remain.
Cost & insurance
Our epiretinal membrane surgery fees are all-inclusive of the consultant, theatre, anaesthetic and a structured follow-up:
- Vitrectomy + membrane peel: from £6,500 per eye.
- Phacovitrectomy (with cataract): £8,500–£11,500 per eye.
- Monitoring: consultation and OCT from £240 if surgery is not yet needed.
- Insurance: recognised by Bupa, AXA, Aviva, Vitality, Cigna and WPA — ERM surgery is functional and usually covered. We handle authorisation.
- Finance: 0% options available to spread the cost.