macular pucker

[romie24]

I have been told I have a macular pucker in one eye.  I can see well with both eyes together,  with my glasses, but not with the poor eye alone.  I've never heard of this before and am not sure how worried to be.  If surgery is needed how difficult a recovery and how dangerous is the surgery itself.  And of course how successful is it?  I will be needing cateract surgery in that eye  pretty soon also.  What to do about that?  With the macular problem should I still get the multifocal lens?  Any other advice?  Thank you so much.

[aneye]

I have macular pucker since 2008 on my right eye. While I was having lunch in a restauratn in April 19, 2012, I suddently saw a lot of cloud in my right eye. I visited my retinal specalist after 2 days. After diagnosed my eyes carefully, he told me that it's good news. The cloud floating in my eye  is because the macular pucker seperated from the retina. It's like a surgery has done to remove it. He said it's very rare. He finds only a lucky one in 400-500 patients. I am so pleased for being so lucky. However, the black cloud is still bothering me. My vision is still 20/40 (it was 20/50 before). I want to know what will be the future of my eye.

I appreciate any opinion!

A. Yu in San Francisco

[JodieJ]

Normal foveal thickness is in the low 200's.  Your current measure (370+) is typical for someone with an ERM.  I suggest that you (1) get fitted with glasses, and (2) consult a retinal specialist.  (See my response to you on the expert forum.)  

[mike230]

Have had a crystalens followed by an RD in the upper right hand corner, caught early stage, repaired with laser, freezing and gas bubble.  In addition a 23 gauge core vitrectomy was done.  This was in 9/08.  In May 2009 noticed a sudden decrease in vision from 20/20 to 20/80.  I was diagnosed with CME 540 microns.  Was and am to this date still using predforte and acular.  The CME is down and holding steady around 372-383microns.  Was told normal is 300 microns to a little less.

I really want the injection along with glaucoma drops, but now my doctor said the swelling is gone and the macular pucker is the cause and did not recommend surgery or the injection and insisted I should be fitted for glasses.

My opthamologist who is a refractive specialist opt to do a PTK or PRK as she said it is safer to tweek the front of the eye than go back in.  What is amazing is I tried a co workers mild myopic glasses and it cleared the contrast and most of the distortion issues??

Right now my vision is 20/40 with distortions.  Could you tell me what you went through with the pucker surgery,  was there a gas bubble used and how quick did your vision recover and were there any restrictions post op?  Thanks

[JodieJ]

With an experienced retinal surgeon and the newer, "sutureless" vitrectomy equipment, your recovery should be pain-free and very rapid.  You will probably be able to drive the day after your surgery.  (I could.)  The major complication of this surgery is accelerated cataract development.  Sometimes cataract surgery is done at the same time as the vitrectomy.

If you cannot see well with you "bad" eye alone, you would probably really benefit from surgery.  But please don't delay it for months or even years.  There's substantial evidence indicating that visual outcomes are better when surgery is performed sooner.

[Ray T Oyakawa, MD]

The surgery for macular pucker is relatively easy for an experienced retinal surgeon.  Recovery is relatively rapid.  Main complications are progression of the cataract and retinal detachment.  Cataract surgery is more difficult after a vitectomy for macular pucker removal.  You may discuss with your doctor the removal of the cataract first and the macular pucker at a later date.  

I would not recommend a multifocal IOL,  Crystalens would be ok.  This all depends on the potential vision after pucker removal.

Dr. O.