macular pucker

[casey59]

I was diagnosed with macular pucker 4 years ago, since then my vision in my eye has gotten much worse, and now the other eye is starting to exhibit the same symptoms.  I feel I will have to have surgery.  I live in the northwestern suburbs of the Chicago area. Whom would you reccomend  for this type of surgery, I understand it is a very difficult type of surgery.
Thank you ,


This discussion is related to How do you find the 'best' retinal specialist?.

[casey59]

I would like to know the name of your general opthamologist.  I was wondering how you came to be referred to Dr. Charles in Memphis. I really don't have a good opthamologist locally, and thought I might see the one you saw.  I had a bad experience with an opthamologist in my area.  I live in Algonquin.  Thank you so much for all of your info.

[JodieJ]

I had two surgeries in the same eye to peel the same ERM.  My first procedure in 2006 used sutures (which, unfortunately, were done by a resident.)  Neither ERM surgery was painful, and I was awake during both.  My eye was patched overnight after both procedures (necessary because the local anesthesia prevents blinking.)  My 2006 procedure was done early in the morning (in Chicago where I live.)  I felt fine immediately afterward.  That afternoon I walked over to the local multiplex and stayed for a double feature.  (Hey, I had the day off work, so why not?)  After the patch came off, l couldn't read anything on the eye chart.  I had terrible inflammation due to misplaced sutures (beware of teaching hospitals!), and it took about three months for my acuity to improve from about 20/50 (before surgery) to 20/20+.  However, the image size in my affected eye had become about 15% larger than the image in my other eye, causing many problems.  (I later learned that this was due to ERM remaining in the macular periphery of my eye.)  I used eye drops for several months after both ERM surgeries.

Modern 25-gauge sutureless equipment was used during my second (2009) ERM surgery in Memphis.  The surgery was done in late afternoon, and I was having dinner at a restaurant less than 2 hours after leaving the OR.  It's true--I could read the 20/20 line the next morning, although my vision was slightly blurry due to inflammation related to the surgery.  (Those sutures are uncomfortable and cause terrible astigmatism until they are removed and the inflammation is gone.  Find a surgeon who uses modern  "sutureless" vitrectomy equipment!)  I had no restrictions, although engaging in activities such as swimming, weight lifting, and roller coaster riding would certainly have been foolish (at least in the days following surgery.)  The image size difference between my eyes improved very slowly, but it will probably always be present to some extent due to the long delay between my surgeries.  (Delayed surgery risks irreversible macular damage.)

An ERM patient on another website stated that ERM surgery is still in its infancy, and there are very few surgeons worldwide who are truly skilled.  I totally agree.  None of the four local retinal surgeons whom I consulted had the skills to remove the smaller pieces of ERM in my eye.  (It's not even clear that they were aware of the remaining ERM.  All of them told me that the outcome of my 2006 surgery was good, and I should go home and live with the problems I was having due to my image size difference.)  I'm convinced that Dr. Steve Charles of Memphis, who did my second ERM surgery, is in an entirely different (and higher) league in terms of his surgical skills.  I'm posting this information to convince others that their choice of surgeon is so very important.      

[mike230]

Were you patched after surgery and you said you had clear 20/20 vision after the patch was removed.  Did I read this correctly?

I work as a laborer performing mostly custodial and snow shoveling tasks.  What did were your restrictions and were you on drops afterwards?

Thanks for your help
mike

[JodieJ]

I had two surgeries in the same eye to remove the same epiretinal membrane (macular pucker).

If you want to stay local, you might consider seeing Dr. Mark Daily in Wheaton (630-668-8250).  I know that he has an excellent reputation.  You will need your ophthalmologist to refer you.  (I've never seen Dr. Daily myself, but I would not recommend any of the Chicago retinal surgeons that I have seen.)  My first choice would be Dr. Charles in Memphis  (www charles-retina com) if you are willing to travel.

It is not that uncommon to develop ERMs in both eyes.  Please don't delay in setting up your consultations(s).  This is not painful surgery, and you have so much to gain by it.

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

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[casey59]

Thank you for your info.  I am starting to have symptoms in my good eye also, did you have ERM in one eye or both? I was diagnosed by Dr. Robert Allar in 2004 he is in Hoffman Estates, at that time I only had a slight problem, he told me to wait and see how it progressed.  It has gotten worse and now that I amstarting to have a slight problem with my other eye, I am really getting concerned.
casey59

[JodieJ]

I live in Chicago and had ERM surgery performed by a highly respected local retinal specialist in 2006.  The surgery restored my acuity but left me with a larger image size in my affected eye.  I subsequently consulted several other respected local retinal specialists, all of whom strongly recommended against having further surgery.  Earlier this year (on the recommendation of my general ophthalmologist), I consulted Dr. Steve Charles in Memphis.  He immediately identified my problem--my first surgeon had left pieces of ERM in my eye.  Dr. Charles implied that many (most?) retinal surgeons lack the skills to remove smaller pieces of ERM.  I had successful surgery to peel the remaining ERM the next day, and I could read the 20/20 line with my affected eye the following morning.  My Illinois Blue Cross worked just fine in Tennessee.  Based on my own experience, I'd strongly recommend that you see Dr. Charles in Memphis.  His staff are very helpful to out-of-town patients.  (I've been told that travel expenses for surgery are tax deductible.)

My ERM surgery with Dr. Charles took less than half an hour.  It was totally painless.  Less than two hours after leaving the OR, I was having dinner at an Italian restaurant (wearing an eye patch) and feeling fine.  I flew back to Chicago the following day.  I'm sure that your surgery will not be the ordeal that you fear.  But please do not delay surgery.  Recent research shows that delaying surgery can result in permanent damage to the macular tissue.  Since my surgery with Dr. Charles, I've had about a 50% reduction in the image size difference between my eyes.  I'm hoping for more improvement, but the 3+ year delay between my surgeries may limit this.  So please schedule your consultation(s) soon.  

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

You need a board certified vitreo-retinal macular surgeon ophthalmologist, and member of the Am Acad of Ophthalmology. There are a number of good ones in private practice and all the medical schools have strong departments.

Find one at www.aao.org

JCHMD