Purpose: To evaluate spectral-domain optical coherence tomography (OCT) findings based on preferential hyperacuity perimeter (PHP) in patients after idiopathic epiretinal membrane surgery. Methods: Forty eyes of 40 patients undergoing surgery for idiopathic epiretinal membrane were included in the study. The best-corrected visual acuity, PHP, Amsler grid test, and OCT were assessed 3 months after surgery. Results: Patients were classified based on the defect of hyperacuity by PHP, as follows:

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... peracuity defect (n = 18 eyes) and hyperacuity intact (n = 22 eyes). There was no difference in age, gender, duration of symptoms, and visual acuity. The average macular thickness and inner nuclear layer thickness in the hyperacuity defect group was thicker than the hyperacuity intact group (P = 0.041 and P = 0.045, respectively). A disrupted photoreceptor layer was more common in the hyperacuity defect group compared with the hyperacuity intact group (P = 0.001). Conclusion: With regard to metamorphopsia, a hyperacuity defect after epiretinal membrane surgery was associated with inner nuclear layer edema and photoreceptor disarrangement.