How well can surgery treat macular pucker?

Macular pucker is a relatively common cause of visual loss and distortion. Macular pucker is caused by an abnormal growth of scar tissue on the surface of the macula. The natural course of macular pucker can be quite variable. In some people, the visual problems are mild and nonprogressive. Usually, no treatment is needed in such cases.

In other people, macular pucker causes a significant and progressive loss of vision. In these cases, the only treatment is surgery to remove the scar tissue. This operation is called a vitrectomy with epiretinal membrane removal. The chance of a spontaneous separation of the scar tissue from the retina without surgery is less than 10%. However if a spontaneous separation does occur, the vision can be as good as with surgery.

The average amount of visual improvement is a doubling of the preoperative vision. In other words, if the preoperative vision is 20/100, it is reasonable to expect a final vision of 20/50. However, it is important to understand that an average means that some people will be significantly better or worse. Reasons for worse vision include retinal detachment (less than 3%), regrowth of the scar tissue (less than 10%), and cataract formation. Nearly all patients who have macular-pucker surgery will eventually require cataract surgery over a period of months to years.

The chance of catastrophic visual loss with this surgery is much less than 1%, but it is possible. The risk of delaying surgery is related to the fact that the better the vision is before surgery, the better it is likely to be after surgery. In other words, if a person waits until the vision is very bad, the chance of good or very good vision after surgery is less. There are many other factors that must be considered when contemplating macular pucker surgery such as the status of the other eye, the patient's overall health and the effect of the macular pucker on the patient's quality of life. In conclusion, for most people, macular-pucker surgery can be expected to improve vision.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.