Macular pucker and cataracts

[goldie1313]

I have both an ERM and cataract in one eye.  After several visits to cataract surgeons and retinal surgeons, I had the idea the cataract surgery is normally done first.  However, if the cataract is classified as a 1 or 2 maximum and the ERM seems to be agressive.(My vision now in this eye is 20/150 or worse) and the retinal surgeon feels comfortable doing the macular peel first and then judging when to do cataract surgery, has anyone had the procedures done this way?  Is there a negative or hopefully, a positive for doing the peel first?   I certainly would like to hear anyone else's experience when having to deal with both the cataract and the macular pucker.

[JodieJ]

There is no need for a gas bubble or "positioning" after uncomplicated ERM surgery.  My surgery last year was done out-of-town.  Two hours after leaving the OR I was enjoying a meal at a restaurant.  I flew home the following day.  I experienced no pain at all.  

[Sandy Feldman, MD, MS]

Dear goldie1313,
When to do the cataract surgery, will depend upon the doctors involved.  If the lens is removed first, positioning following epiretinal membrane surgery might be easier for you so as to avoid the gas bubble near the lens.  Cataracts are likely to be worsened so the postoperative course may be more difficult for you.  Speak with your doctors about the rationale for their approach.

Dr. Feldman

Sandy T. Feldman, M.D., M.S.
ClearView Eye and Laser Medical Center
San Diego, California

[JodieJ]

I'd recommend that you find a very experienced retinal surgeon and follow his/her advice about the order of procedures.  Surgeons have different preferences, with major consideration given to their ability to visualize your retina.  I don't think that going by other people's experiences would be a good strategy in your case.