Macular Pucker surgery...to do or not to do?

Hello everyone, I'm needing some shared experiences PLEASE.
Last week I was diagnosed with rather severe Macular Pucker in one eye.  I noticed a decline in vision for several months prior, but thought I had an infection from eye makeup.  Saw a retina specialist yesterday , seeing a second opinion Friday but I am expecting the same news.
The pucker is pulling on the retina and nerves a bit and has made my vision in that one eye 20/200 and no corrective lenses will help at this point.  I can still see light, shapes etc. but just cannot make out letters.  I can live with it like this, but the specialist says the tugging my cause more severe damage so I have nothing to loose by doing the surgery right away for the best chance of any improvment.

That is where I'm having the problem ,,,I am 56 and still lead an active life on the lake with waterskiing etc.  I have never needed surgery or prescriptions and take care of myself with exercise and diet.    
I do not want to enter into a lifestyle of surgeries, infections, potential real dangers with retinal detachment or reoccurance of the pucker...etc etc.  Yes, I know every surgery has risks and I should just suck it up, but the fear of making the wrong decision is stressing me greatly.  The Dr. cannot tell if the pucker stabilized or will cause more damage...so do I just leave "well enough alone here"??

Does anyone out there have a similar experience with Macular Pucker surgery ?  I would appreciate any and all comments !

[Ray T Oyakawa, MD]

You need to have surgery.  I have had macular pucker surgery (in addition to other surgery starting with a retinal detachment) for a vision of 20/200  My vision has recovered to about 20/20 with some distortion.

20/200 is legally blind.  Get this eye fixed.  I have seen patient who have not a surgery in one eye for a correctable problem and years later they develop a problem in the one remaining eye that can not be fixed.  At the time is was too late to fix the problem in the first eye.

Dr. O.

[JodieJ]

At this point you have already lost your depth perception (not great for waterskiing), and things will not improve without surgery.  Definitely get surgery--performed by a retinal specialist who is experienced with this procedure.  And keep in mind that the best visual outcomes are associated with early surgery.  I predict that your surgical experience and recovery will be SO much easier than you are anticipating.

[homecrafter]

I so appreciate your comments as I am having an extremely hard time with this.  I'm wondering also if Macular Pucker ever gets mis-diagnosed and maybe I just have Macular edema which will go away on its own?
Hopeful thinking or are there easily mistaken other diagnosis's that even the retina specialists can get wrong.
I only had the OCT test and seem to be jumping into surgery fast, but the 20/200 within  less than a year concerns me.  Would they know from the OCT and exam if it was some type of cancer instead of Macular Pucker ?

Did your Dr. use a steroid injection during, but at the end of the surgery ?  My Dr. says it's optional because it can cause cataracts I much faster than normal, I believe.  What is the advantage / disadvantage of this steroid into the eye during surgery?   I don't like drugs in general because of side effects, but if something is absolutely in my best interest I don't want to be foolish about it either.  

[JodieJ]

I believe that a macular pucker can be diagnosed by a retinal exam alone.  I think it is extremely unlikely that you were misdiagnosed.  I did not have a steroid injection before or during surgery.

I've had surgery to peel a macular pucker twice.  This is not painful surgery.  I was awake both times and felt no pain at all.  I spent the afternoon following my first surgery at the local multiplex.  My second surgery was done out-of-town, and I was having dinner at a nice restaurant less than 2 hours after leaving the OR.  I flew home the following day.  You could probably return to work the day after surgery if you really wanted to, although your eye might be slightly red and swollen.

You have so much to gain from this surgery.  Please don't postpone it.

[homecrafter]

Hello again, Just got a second opinion on my Macular Pucker.  Apparently there is quite a lot of scar tissue built up over my macula and it's causing traction on the nerves, but MAY or may not have stabilized at 20/200.
Looks like surgery to remove the scar tissue should be done asap.

NEW QUESTION:
This second surgeon suggested doing the cataract lens replacement surgery on that eye the same time as the macular pucker surgery. (even though I only have a slight beginning of cataract)

#1)  Is that too much trauma for the eye all at once ?

#2) He said, (and we've read) that cataracts are almost a guarantee rather soon after this surgery, so if you just do it at the same time you reduce the risk of a second surgery soon afterwards.   That part makes sense, but I was "frozen" in the office and didn't think to ask about all of the downsides to doing the lens replacement at the same time.
Maybe he thinks I won't have that great of an outcome anyways with my macular pucker being so extreme so what would I have to lose ?  

Does anyone have any experience or research on that ??????  Surgery is scheduled with this Dr. next Thursday, so I don't have long to research this, please help.   thank you in advance !!!  

[JodieJ]

Congratulations on your decision to proceed with the pucker surgery!  The practice of doing cataract surgery at the same time is somewhat controversial.  On the "pro" side, you will not have to anticipate having a second eye surgery sometime during the next year or two.  On the "con" side, some surgeons (including Dr. Charles of Memphis who did my second ERM surgery) claim that the final visual outcome is better when the two surgeries are done at different times.

I suspect that there is not much difference in visual outcomes, although I have a personal bias about this issue.  I was ultimately very glad that I didn't have cataract surgery on the same date.  I was really thrilled with the outcome of my cataract surgery.  I attribute my excellent results to my choice of an experienced cataract surgeon, who used multiple formulas to determine the appropriate IOL power for me.  (I had been a high myope with astigmatism, so my health insurance covered the cost of getting my second eye done.)  The time delay between retinal and cataract surgery allowed me to research the issues involved in choosing an IOL and the options available for my new vision.

If you want more input about your question, try posting it as a separate thread on both eye care forums.  

[rita67401]

Please keep us posted on your surgery outcome.  I was diagonsed with exactly the same thing just this week.  I too thought the problem was caused by getting makeup in my eye but found it is a severe macular pucker in my right eye.  My vision is now very blurry and distored.  The doctor asked me to wait six weeks because sometimes the membrane will disappear on its own. He did say the surgery will restore the vision but it will take 4to 6 months before it returns to normal. He went on to say that developing a catarac is guaranteed.  If this isn't better in six weeks,I'm going to opt for the surgery.