Long-term results of macular pucker surgery

Macular pucker patients were re-examined 16-90 months after surgery (mean 72 months) to evaluate visual acuity, metamorphopsia, and complications, with particular reference to cataract development. Surgery had been performed on 48 eyes in 46 patients, 31 eyes having a primary, and 17 eyes a secondary macular pucker.

At the 6-month control 65% of the eyes with a primary macular pucker and 35% of the eyes with a secondary macular pucker exhibited an improved visual acuity defined as doubling or more of the visual angle. At the last control 57% of the primary group and 33% of the secondary group had a visual acuity which still exceeded the preoperative value. At the final examination a cataract progression was observed in 22/28 (79%) of the primary group and 8/14 (57%) of the secondary group. In the primary group 11% and in the secondary group 36% of the eyes suffered a retinal detachment. All cases were successfully treated and none were followed by visual deterioration.

The improvement in visual quality after macular pucker surgery appears to be long-standing, if not permanent, especially in primary cases. In those eyes in which a decrease in visual acuity is observed, the most frequent cause is cataract development.