To investigate the participation of residual fragments of epiretinal membranes (ERMs) in recurrent ERMs after pars plana vitrectomy (PPV) for ERMs.

Retrospective comparison study.

Consecutive 195 eyes of 195 patients with ERMs who underwent PPV.

Internal limiting membrane (ILM) was removed without use of Brilliant Blue G (BBG) dye in any eyes until May 2017 (group 1) and thereafter using BBG dye in all eyes (group 2). Optical coherence tomography (OCT) images were obtained 3 days and 3 years after PPV.

Group 1 was made up of 87 eyes, and group 2 was made up of 108 eyes. OCT images obtained 3 days after PPV showed ERM fragments with retinal surface wrinkling in 53 eyes (27.2%) and retinal surface wrinkling alone in 9 eyes (4.6%). OCT images obtained 3 years postoperatively showed ERMs in 63 eyes (32.3%), all of which except 1 eye had ERM fragments and (or) retinal surface wrinkling on OCT image 3 days after PPV. Residual ERM 3 days postoperatively grew in 20 (64.5%) of the 31 eyes with residual ERM 3 days postoperatively in group 1 and 5 (22.7%) of the 22 eyes with residual ERM 3 days postoperatively in group 2, which rates were significantly different (p = 0.003).

ERM fragments may be the source of recurrent ERMs after PPV, and ILM peeling assisted with BBG dye may prevent growth of residual ERM. Eliminating ERM and ILM fragments intraoperatively may effectively reduce another surgery for ERM peeling.