Macular Pucker

Macular Pucker

What Is a Macular Pucker?

You have developed a condition known as macular pucker. This problem (also known as epiretinal membrane, cellophane maculopathy, or surface wrinkling retinopathy) is usually the result of aging changes on the surface of the retina where the vitreous gel is in contact with the retina.

How Is Macular Pucker Caused?

There are other much less common causes, but generally, it is simply an aging process. The effect is a distortion or blurring of the central, focused vision. The peripheral vision is usually not affected at all. Although there may occasionally be other symptoms such as floaters, it is the distortion and blurring which is most troublesome. This distortion of the vision is the result of a fine layer of tissue which has grown on the surface of the retina and caused it to wrinkle much like ripples or creases in wallpaper on a smooth wall. Usually the vision is not severely affected, and this tends not to be a progressive problem.

What Treatment is Available?

Patients with a fairly severe macular pucker might choose surgery, which is the only known treatment option for this problem. The surgery is called a vitrectomy and consists of removing the vitreous gel and the abnormal piece of tissue which is wrinkling the retina. The surgery generally takes less than one hour, can be done under local or general anesthesia, and is usually done as a day surgery (in and out the same day) procedure. Usually the eye is minimally irritated afterwards, and patients resume normal activity within a few days.

What Is the Benefit of Surgery?

The benefit of surgery on the vision is hard to predict. Although most patients do notice some improvement after surgery, it is impossible to predict how much, if any, vision may be recovered with surgery. In general, a fairly “fresh” pucker will improve more significantly than a very long-standing one. Vision improvement is generally slow with a gradual reduction in distortion symptoms over weeks to months.

Do I Have a Choice?

Surgery for a macular pucker is elective, and as with any procedure, there are risks. Fortunately, complications are infrequent, but should they develop (such as retinal detachment, hemorrhage, or infection), they can cause severe loss of vision. It is relatively common to have some degree of cataract (clouding of the lens) development or progression months after surgery. Patients who elect to have surgery for a macular pucker should be aware that cataract surgery may be indicated at some point in the future.

In general, the other eye is not similarly affected, although occasionally both eyes will develop a macular pucker. Surgery on the first eye has no affect on the possible development of a similar problem in the other eye.

If you have any additional questions or concerns, please ask the doctor or a member of the staff.