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Macular Pucker Surgery Timing

Hi there,

I'm 32male, asian, from jakarta. I had my mac-on retina re-attachment surgery on 23 may (Left eye) .2 week After the surgery, my vision is 20/50 ( with glasses), with white blindspot near central vision but no waviness. 1 week later, i had sub-clinical re-detachment, which doctor did a laser treatments to double the laser stitches. However i notice incrimental visual deteritration over-time and on 12 july i notice a waviness, did an OCT and diagnose with macular pucker. I already went to many surgeons and all of them said wait and observe. 2 weeks later the macular progresivelly worsen and my central vision is so blurry and distorted i no longer able to read big text. It seems surgery is unavoidable.

My Question is,

1. In my case, when is the right time to do macular pucker surgery after you have retinal reattachment surgery to achive a good visual acuity? i heard if you wait to long your original visual acuity wont come back.
2. is it save to do sub-clinical retina re-atachement surgery at the same time with macular pucker? i heard surgeon will inject steroid into your eyes. My eye preasure is tend to go up very easy. i'm afraid gas or silicon oil complicated things.

Thanks again for reading this! looking foward for your opinion.
1 Responses
177275 tn?1511755244
There is no "right time" to do macular pucker surgery. Most cases of macular pucker (also known as epiretinal macular membrane or ERM) do not need surgery. When ERM is combined with retinal detachment and perhaps fluid (edema) in the macula then there is often disagreement among retina surgeons when and if to do surgery. So your first question cannot be answered on this forum.   Your second question cannot be answered either. Sub-clinical RD usually do not require treatment.  If it is treated its usually just to close a retinal hole that has not caused a RD and laser or freezing (cryo) is used.
My ERM comes from vitrectomy and it  progressing really quick in the past 2 weeks. It's already affecting my daily life. i can no longer read and drive. visual acuity not even 20/200 and distorted.

From what i read in many eye clinic or hospital websites, it need to be taken out as early as possible to get your VA as much as possible. Is that true?

No it is not true. As I said most ERM not require surgery. However if yours is growing quickly and causing a great deal of problems then surgery may be appropriate. Your retina Eye MD ophthalmologist is the only person that can discuss your problem as these are all different.
Ok thank you
Best of luck
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