Randomized Trial Comparing Immediate vs. Deferred Surgery for Symptomatic ERM

Key Inclusion Criteria: * Age ≥ 45 years * E-ETDRS visual acuity 20/40 or better (≥69 letters) o ERM must be thought to be the primary cause of vision loss * ERM meeting the following criteria, according to the investigator * ERM is not secondary to another condition * Symptoms of visual loss and/or distortion (in the opinion of the investigator, the ERM is contributing to the participant's symptoms); either new or worsening in the past 24 months * Epiretinal membrane involving or altering the central 3 mm of the macula on OCT * Distortion within the central subfield due to ERM on OCT * Immediate vitrectomy not required (investigator and participant are willing to wait at least 4 weeks to see if vision remains stable without having to proceed to vitrectomy) * No known medical problems that will be a contraindication to surgery Key Exclusion Criteria: * History of retinal vascular disease * History of vitreous hemorrhage if vitreous hemorrhage is thought to have caused the ERM o History of vitreous hemorrhage is permitted provided the vitreous hemorrhage did not cause the ERM in the investigator's opinion * History of inflammatory disease unless mild and completely resolved at least one year prior to randomization * History of diabetic macular edema (DME), retinal vein occlusion (RVO), or uveitis (except mild uveitis that resolved \>1 year prior to randomization) * Prior intraocular surgery (except uncomplicated cataract extraction) * Cataract extraction within prior 3 months * Laser or cryosurgical retinopexy within one month of randomization * Pneumatic retinopexy within one year of randomization * Current untreated retinal tear or detachment o A previously treated retinal tear with up to one disc diameter radius of subretinal fluid is permitted * Macular hole * Degenerative lamellar macular hole o ERM foveoschisis ("tractional" lamellar hole) is permitted * Vitreomacular traction within 1,500 microns of foveal center * Central serous chorioretinopathy * Nonproliferative diabetic retinopathy or worse (DR severity \>20)