Macular Pucker Treatment & Options

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Macular Pucker Treatment

When you conclude your career, your eyesight may want to retire with you too. Among the many eye health issues that you might face at this time is macular pucker. With this condition, a thin layer of tissue forms on the light-sensitive eyes cells, obscuring vision. Macular pucker treatment—surgery can save your eyesight.

A macular pucker causes vision deterioration. In some cases, this can impact your daily activities and quality of life. Get regular eye exams, and you might arrest it before it causes massive damage. Life begins anew when you retire, you will need your eyes for that.

What is Macular Pucker?

A macular pucker is scar tissue that forms on the eye’s macula. The macula is at the heart of the retina and is a hub of tissues that do the actual seeing. The macula makes possible sharp and color vision that you need for driving, reading, and seeing small details. Macular pucker affects central vision.

The eyes are filled with a gel-like clear substance called the vitreous humor. It assists the eyes with maintaining shape. But with old age, this fluid layer shrinks and pulls from the retinal surface. The phenomenon is called vitreous separation. It happens to many people.

In some cases, however, vitreous separation can cause damage to the retina when the fluid shrinks and pulls away. If this happens, the retina triggers a healing process at the damaged places, forming scar tissue.

The scar tissue, called the epiretinal membrane, attaches firmly to the surface of the retina. But when it shrinks, it results in wrinkling or puckering on the retina. This may not affect central vision. Nonetheless, if the scar tissue is located over the macula, the condition distorts central vision.

Is Macular Pucker Equivalent to Age-Related Macular Degeneration?

Macular pucker is not age-related macular degeneration. However, because they both affect the macula, they have overlapping symptoms. For example, in both cases, patients report wavy, blurry vision in the center of their visual field. But unlike AMD, which often develops in both eyes simultaneously, macular pucker doesn’t have any preference for developing in one or both eyes.

A retinal ophthalmologist is a medical specialist with the expertise to treat macular pucker. Macular pucker treatment is different from AMD treatment. Macular degeneration is treated medically, while macular pucker is treated surgically.

What Is the Difference Between A Macular Pucker and A Macular Hole?

In both conditions, patients have shared symptoms such as blurry and distorted vision.  Both macular pucker and macular hole result when the vitreous contracts and pulls on the retina.

Even so, a macular pucker is not the same as a macular hole. The latter is a break or ‘hole’ in the macula that results when dynamic vitreous contraction tears the retina.  In other words, a macular hole occurs when forces on the retina pull it apart, while macular pucker tends to draw the retina together.

What Are the Signs of Macular Pucker?

If you notice that the center of your vision is blurry or lines are wavy when reading a book, you may have a macular pucker. You may experience issues in seeing fine detail and reading small fonts. In some instances, there is a blurry spot or a gray area in your central vision.

Please note that these symptoms may indicate something else, including AMD and macular holes. Visit an eye MD for an accurate diagnosis and comprehensive macular pucker treatment. The ophthalmologist will conduct a dilated eye exam or take advanced imaging of your retina via optical coherence tomography (OCT).

What Can You Do for Macular Pucker?

Observe: In many cases of confirmed macular pucker diagnosis, the condition is mild. If it doesn’t severely impact vision, the doctor may choose to leave it alone.

Surgery: For severe and advanced macular pucker cases, the condition can be treated with surgical removal of the membrane.

Is there any treatment for macular pucker?

Depending on the diagnosis, your doctor may suggest not treating macular pucker. Even so, expect a recommendation for regular eye checkups as the specialist will need to track the condition. For medium to high severity cases, they may prescribe surgical intervention.

Surgery for Macular Pucker

Besides observation, surgery is the only option in macular pucker treatment. The procedure for macular pucker is usually performed under local anesthesia. You’ll be awake through it, but you won’t feel pain.

The first part of the medical procedure includes removing the vitreous gel that fills the eye.  This step is called a vitrectomy.  The surgeon will use small instruments to cut the vitreous and remove it. The tools used to make the incisions usually are about half a millimeter wide. Removal of the vitreous gel can help eliminate retinal tugging or provide better access to the retina to remove scar tissue.

Next comes the stripping off of the cellophane-like scar tissue. The specialist will eliminate the epiretinal membranes that are causing the macular pucker. This will allow the macula to relax back to its normal shape against the back of the eye for good vision.

What happens during a macular pucker surgery?

  • It’s an outpatient procedure done in an ambulatory surgical center.
  • Vitals are monitored using oxygen, blood pressure, IV, and EKG sensors.
  • The eye is numbed, and IV sedation may be used for patient comfort.
  • The eye is cleaned with antiseptic, and the eyelid is kept wide open with a speculum.
  • A surgical microscope is used to magnify the view
  • Instruments are inserted through the ‘safe zone’ white part of the eye.
  • The retina specialist uses a vitrector to remove the vitreous delicately.
  • The eye is filled with vitreous substitutes, usually, a form of saline called “balanced salt solution”.

What Is the Success Rate for Macular Pucker Surgery?

On average, patients can regain 50 % of lost or distorted vision. Results vary from one patient to another.

Macular pucker surgery restores part, not all of the lost vision. It stops further deterioration of central vision from the condition. Recovery of vision may happen after several weeks following the macular pucker treatment procedure.

What Are the Dangers of Macular Pucker Surgery?

The most widely recognized side effects of a vitrectomy include elevated risk of cataract formation. Some patients end up needing cataract surgery within a few years after the vitrectomy. The procedure itself has rare complications, including bleeding, infection, retinal separation, and vision loss.

What Occurs After Macular Pucker Surgery?

The sedation wears off quickly, but you will need a driver to get home. After the procedure, you should wear an eye patch overnight to protect the eye. Your retina specialist in Sarasota will prescribe eye drops to help with healing.

Will Macular Pucker Heal Itself?

In rare instances, the scar tissue that causes the macula to wrinkle may relax on its own. In other cases, however, the condition drastically affects vision and severely impacts daily activities.

A Legacy of Excellence in Eye Care

At Retina Care Consultants, we believe that you deserve access to the best eye care. We provide a comprehensive and coordinated care framework from straightforward to sophisticated retinal specialties.

Contact us to set an appointment for an eye exam and macular pucker treatment.

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