Macular Pucker dilemma

[kathgd]

In the last year I have had 2 cataract surgeries and now I have secondary cataract in one eye and Macular Pucker in the other.  The secondary cataract should be an easy fix, but there is a problem.  I work in television.  My eyes are my life.  I focus digital cameras on a single eyelash and do complex detailed computer editing that requires perfect eyesight.  Needless to say, it has been a tough year or so.  I'm fairly young (54) and in great health, so what gives??
For some reason, even minor surgeries in my body produce excess scarring and adhesions.  I think that may be why the Macular Pucker developed.  I had a normal vitrious detatchment several years ago in each eye, with follow-up examinations, so that shouldn't have been a problem... obviously, I was wrong.  Is this career I love over?  "OK" eyesight is not acceptable in this industry.  The headaches and strain trying to focus has been difficult. Now what? Can the prognosis be good?

[John C Hagan III, MD, FACS, FAAO]

-

[JodieJ]

As you said, the secondary cataract should be easy to fix, leaving you with (more or less) "perfect" vision in that eye.  But expecting "perfect" vision in the eye with the macular pucker may not be realistic.

I did many hours of research and consulted more than one retinal specialist before deciding to have surgery to peel the macular pucker (aka epiretinal membrane, epimacular membrane) in my eye.  Most of the research articles gave surgical outcomes in terms of the ability to read an eye chart with the affected eye (with no regard for contrast sensitivity or the ability to use both eyes together.)  One Japanese article did say that even with 20/20 acuity, post-surgery vision is NEVER "perfect;" there is always some degree of distortion and/or loss of contrast sensitivity in the affected eye.  In my case, my vision in my affected eye improved from about 20/50 to 20/20+ post-surgery, but I have very mild distortion (most apparent when reading) and an increased image size.

My best suggestion would be to get recommendations from two or three of the very best retinal specialists (who are experienced in vitreoretinal procedures) in your area.  It wouldn't hurt for you to do some independent research, too.  There's a wealth of current information accessible through Google and pubmed.

[John C Hagan III, MD, FACS, FAAO]

No its not good. If your profession requires "perfect" vision then because of your eye conditions you will never have perfect vision.  

Get a couple of extra opinions on your situation with Eye MD ophthalmologists.

JCH MD