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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 !
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177275 tn?1438375244
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Can someone recommend top surgeons for epiretinal membrane in Chicago area?
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177275 tn?1438375244
answered in your other post
JCH MD
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I just had this done October 1st, will post up my experience with it as it goes.
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177275 tn?1438375244
OK  please do
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I first noticed distorted lines and the perception of looking through water droplets on September 14th, and what got my attention was how quickly it seemed to happen.  I went to our Dr. of Optometry a week later and while there had an OCT scan that showed very clearly the unhappy retina.  I was immediately referred to a specialist and was seen that same day.   He suggested the surgery be done and I was in complete agreement, given how this was affecting my central vision so significantly.  It's been a week now since I had the surgery and so far so good.  I was given the gas bubble but it continues to shrink nicely.  My pupil that stayed dilated for the week following surgery has also returned to almost normal.
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One additional symptom of note was that images in my affected eye were generally smaller than with my unaffected eye.  My grandmother had AMD back in the day and my first thought was maybe that was the condition I had, although I never experienced a blind spot in my center vision.  I have still not seen anyone report a sudden onset of symptoms from macular pucker like I seemed to experience.  In hindsight (no pun intended) I did notice a rather vague change in vision while wearing reading glasses over maybe the two months prior, but nothing else except maybe a little more difficulty seeing in low light situations.  I have worn contacts daily since the late '70s, and have them for distance correction only (hence the reading glasses for close-up work), but of course have not worn them since this experience started.
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Do you still see smaller images in one eye?
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I do but it is somewhat less pronounced than before having the procedure done.  It's been less than two weeks, but my vision in the affected eye is certainly no worse now overall than before the surgery.  Looking forward to slow improvement over the next several months.
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Images in my right eye are 13 percent smaller.  I have Dragged Fovea Diplopia Syndrome which interferes with central fusion.  I use a small piece of Scotch Satin Tape on the inside lens of my right eyeglass lens. It forces me to use peripheral vision which can fuse.  You may be interested in this article
http://ce4optometry.com/web/mediconcept/CRO_24.6_Gorner.pdf

Best wishes
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Thanks CBCT, and good article.  I saved it to my desktop.  Thus far I am not experiencing diplopia as described in the article.  Interesting that a relatively simple solution is available by using the Scotch Satin Tape!  
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Returned for a follow up today (10/13) with my ophthalmologist.  He said everything looks fine, macular pucker has been corrected and two peripheral retinal tears revealed during the surgery are holding fine after laser treatment.  Vision in affected eye 20/50 and unaffected eye 20/20 (both with glasses), IOP 14 mm Hg in affected eye and 13 mm Hg in unaffected eye.  Still some distortion, but both he and I are pleased this far with my results.
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177275 tn?1438375244
Excellent news JCH MD
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Thank you Dr. Hagan.  I will update this again when I see my ophthalmologist for another follow up appointment next month.
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I was diagnosed with a macular pucker in my left eye last year, but it is progressing at a slow enough rate for me to postpone surgical decisions for now.  I DO appreciate all the input about getting second and third opinions, etc.  Wanted to pass along something I discovered that was a real, well, 'eye-opener'.  I found these rather 'silly' plastic glasses at the dollar store that are supposed to provide 'rest for weary eyes' while you keep your eyes open.  They are essentially black plastic glasses with dozens of tiny pinholes in each lens.  Because my right eye is fine, I punched-out that black lens and kept the left one intact.  When I wear the glasses, it's as if I'm giving my brain a rest from the usual slight distortion I'm having all the time.  In short, it's like wearing a patch over the bad eye, but without losing any depth perception, because you are still getting light in the 'bad' eye thru the pinholes.  Those of you who are resorting to patches, try taking one and simply adding some tiny pinholes and you'll see what I mean. It's like a whole '3rd' way of seeing; like a welcome 'trick' to the brain
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177275 tn?1438375244
Thanks for the suggestion  JCH MD
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Returned to my ophthalmologist on Nov. 10, a little moe than five weeks after surgery.  Still noticing slow visual improvement, now about 20/35 in the affected (left) eye.  He did an OCT scan which now shows a flat, normal retinal image instead of the unhappy retina of Sept. 22.  I will see him again in February and will report back how it goes.
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I've just read your question about whether there were any alternatives to 'simply' wearing a patch over the 'bad' eye and carrying on.  Well, I believe I have found one.  I was diagnosed with a macular pucker and will have surgery soon.  In the meantime, I found these rather 'silly' plastic glasses at the dollar store . . . some Japanese 'remedy for tired eyes' that are just black lenses with lots of tiny pinholes in them.  I took them home and punched out the right one (my good eye) and now wear them for relief from fighting the distortion with both eyes open.  It's as if I am 'tricking' my brain.  When I put them on, my brain says: "Oh, this is just a different distortion (like wearing a veil over the bad eye)."  Try punching many small pinholes in your patch and see if you don't get the same effect, without the loss of depth-perception that a solid black patch gives you.
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How long do you wear these glasses?  Just to give your eye a rest?
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I had macular pucker surgery in July. Before the surgery I had very clear vision, but severe distortion. After the surgery, my vision was 20/200. Initially my surgeon could not tell me why my vision changed so radically. Then, he suggested that a the pre-surgical cataract grew rapidly after the procedure and that was causing my vision loss. In November, I had cataract surgery with a lens implant. My vision is still 20/200, but somewhat correctable with glasses. The cataract surgeon told me that because I had previous LASIX surgery, it was more difficult to gauge what lens to use for the implant. Hm...To top it off, my macular pucker is back. In retrospect, I should never had had the vitrectomy.
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kaugirl2, have you had an OCT scan since being diagnosed with a return of the macular pucker?
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Returned to my ophthalmologist on February 9th, a little more than 4 months after surgery.  Vision in affected eye appears to have settled out to 20/50, IOP was 15 in affected eye and 17 in the other, and have been cleared to return to my optometrist to update my glasses.  Will hold off on returning to contacts for a while longer.
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Went to my optometrist on 2/25 to update my lens prescription, appears that my left (affected) eye will at this time be correctable to 20/30.  As somewhat expected following a vitrectomy, the early stages of cataract development have begun, but I will only need to take a watchful approach toward that for now.  
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177275 tn?1438375244
Thanks for the follow up. Best of luck
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Sorry for taking so long to answer about how long to wear the 'pinhole' eye-patch/glasses.  The answer is simply as long as you like and/or can tolerate.  It's just an alternative way to get a rest from the distortion and blurry vision in the bad eye.  I'm scheduled for mac pucker surgery in a few weeks, thanks to all I've read in this forum.  I'm at 20/200 in the bad eye and don't want to wait.  Nothing to lose at this point.  Odds are in my favor I will at least experience some improvement.
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Actually, this past week I had the second surgery for macullar pucker. The first was put off for a year, then the distortion was going to prevent my passing my driver's test, so I had it done. Sight improved for well over a year, to about 20/40.
This time was the other eye, minor distortion. Then one day, shortly after a steroid shot for allergies, I had major distortion. My surgeon, whom I saw every six months, got me right in after I told him the Amsler grid was suddenly grey in the middle, and snarled like fishing line. I was given Avastan shot that day, and for two month to get rid of edema and vision went fro just the E on the chart, to four lines down. Finally, I had the surgery and am in the first week right now. The second day after, distortion on the grid was both ways. By the 6th day, it was just vertical, and today (10th day), even that is milder. I do not have great vision, with grey blank spot which comes and goes, but so do the black specks which always follow. I can see the E on the chart, and sometimes a couple more lines, sometimes not
Having been through this before, I have a wait and see approach. Doc said I may need the shots again after surgery, or maybe not. I know they told me my other eye would improve for six months, but my optometrist said it continues to improve six years later. I know also that my brother in law, originally on Avistan shots for macular degeneration was legally blind, but after being put on Eylea shots this year, is at 20/40 vision! I am glad I had the vitreus removed, as I did not want retina detachment from that. It will be what it will, but there are several options out there, and I am pleased with the results in the first eye done. I will follow doc's advice, as he has earned my trust as a fine surgeon.
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my retna specialist says they like to remove the cataract at the same time they do  the macula pucker surgry
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my retna specialist says they like to remove the cataract at the same time they do  the macula pucker surgry
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Hi Luvtoski,
Did your blind spot go away?  
And what was the cause?
Thanks
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Hi Rita,
How was the surgery?
Thanks
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I notice you have a similar screen name to mine and didn't want confusion, but wondered whether you did in fact decide to proceed with the pucker surgery.
I have the membrane but while at first was opting for surgery right away have decided to hold off and give myself some additional time to consider.  
Wondered what happened as I read this thread and then didn't want our names confused. :)
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I noticed this poster's last comment was regarding a particular clinic in 2015 where the surgery was planned, but unless I missed something, I did not see a follow up account of his/her surgery having been done.
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20792304 tn?1507834735
I'm reading this in October 2017 and it's super helpful. I was just diagnosed with Macular Pucker yesterday. It happened suddenly. I woke up one day about 2 weeks ago and saw a round circle with squigly lines around it and then I started having a hard time reading the computer monitor. I work online and use dual monitors so this is a big issue.

My biggest issue is that my vision is 20/20 when I use glasses so they don't want to do the surgery. They let me know the risks and that it is a delicate surgery and the good chance for cataracts.

I have eye pain now, the kind you get when you know you need glasses and your eyes are straining to see. So one question I have is can I get computer glasses to see the computer screen better and maybe it will help with the pain? I use my reading glasses to read close and prescription glasses to see far. The real problem is somewhere in the middle.
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177275 tn?1438375244
epiretinal macular membranes (ERM) the cause of macular pucker are not painful. Your problem sounds a lot more like eye strain.  You may want to consider going to no line progressive multifocal "bifocals" as you need a different prescription for different distances and only way to address is with multifocal glasses.
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20792304 tn?1507834735
Thanks for the info. I just ordered computer glasses which may help. I did go to a Retinal specialist though and they diagnosed me with Mascular pucker so I also have this I believe as well as eye strain. But you are saying there should be no pain from straining to see my computer monitor because of the Mascular Pucker right?
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177275 tn?1438375244
I'm saying macular pucker is not painful even severe ones.  Eye strain whatever the cause is uncomfortable. Your problems with reading, computer, near tasks sound more like "Presbyopia" if you are mid-40 or over. If you are you should probably make your peace with progressive multifocal glasses.
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20792304 tn?1507834735
Gotcha. Thanks for the reply
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since you have been diagnosed with macular pucker it wouldn't hurt to look at an Amsler Grid periodically for changes.  They are readily available online for download and you can also view them right on your monitor
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