Seeking advice on surgery for Macular Pucker

Discussion in 'Laser Eye Surgery' started by macpuckergal, Mar 26, 2007.

  1. macpuckergal

    macpuckergal Guest

    I'm considering vitrectomy surgery for macular pucker and am
    interested in other people's experiences with this type of procedure.
    Would appreciate any helpful advice. Thanks!
    macpuckergal, Mar 26, 2007
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  2. macpuckergal

    Jane Guest

    My experience has to be an exception rather than the norm, but maybe
    not such a rare exception. I had a vitrectomy with epiretinal
    membrane peeling in January 2006. My vision in the affected eye went
    from about 20/40 to better than 20/20 post-surgery. Of course, I
    developed a cataract, but that wasn't such a bad thing because I went
    from being a high myope to having 20/20 uncorrected vision. (I did a
    lens exchange in the other eye.) But there's been a major down side.
    My affected eye teared continuously post-surgery, for which I was
    prescribed a variety of dry eye remedies. I also noticed that objects
    viewed from my affected eye were larger than those viewed from my
    other eye. I told my retinal surgeon, my cataract surgeon and my
    optometrist about this, but no one found it significant. About 10-11
    months post-vitrectomy, I also noticed that distant objects seemed to
    be on the verge of doubling. (And occasionally did double.) I began
    doing my own research into my symptoms (tearing, binocular vision
    problems) and diagnosed myself with retinally-induced aniseikonia.
    (Aniseikonia involves a disparity in image size between the eyes and
    involves a number of possible symptoms.) Apparently, the epiretinal
    membrane had damaged my macula, compressing the retinal receptor
    distribution. The blur from the epiretinal membrane masked the
    damage, and the peeling revealed the problem. Since there are no eye
    care providers in my area who treat aniseikonia, I've been forced to
    coordinate my own treatment. Ironically, most treatment methods
    involve blurring the vision in the affected eye. I probably would
    have been much better off if I had not had the surgery, and I would
    certainly have been spared a lot of anxiety.

    If you do opt to remove your pucker with a vitrectomy, I would suggest
    two things. (1) Find the very best retinal specialist in your area.
    (2) Use the new 25-gauge vitrectomy equipment (as opposed to the 20-
    gauge equipment). Recovery is reported to be much faster.
    Jane, Mar 26, 2007
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  3. macpuckergal

    fbuholzer Guest

    I can reassure you to have this procedure done. I am grateful to my
    ophthalmologist to urge me to have it done. At the same time I
    recommend that you try to find the best available eye surgeon, who has
    much experience with this operation. I asked my surgeon how many times
    he had performed it. He said he does it 440 times per year and in the
    last 20 years had done it 6000 times. My ophthalmologist had
    recommended this particular doctor ond did not think so well about
    another hospital.
    I was diagnosed macular pucker, epiretinal membrane, 8 years ago on my
    right eye. 4 years later my left eye began to develop it also. I was
    reluctant to have it operated because I am not fond of my eyeball
    being pierced or stung or whatever horrible things one can imagine.
    But blurred vision and straight lines turning curvy got worse, so I
    followed the advice of my ophthalmologist to have it treated. The eye
    clinic of the Lucerne (Switzerland) has an excellent reputation. I had
    an interview with the performing doctor, and he was very confidence
    inspiring. I would first have the right eye operated. The left eye
    could follow 3 months later. The operation would last for about one
    The operation consists mainly of removing the vitreous body and
    removing the membrane causing the problem. I addressed the often
    mentione problem of a cataract developing in the year after the
    operation. The doctor said they routinely do the cataract operation
    preventively at the same go, so there would not be the need to have it
    done later.
    I had the operation 3 weeks ago. It was under local anesthesia. The
    injection of the anesthetic beside or behind the eyeball was painless
    as a short acting sedating agent was injected intravenously in the arm
    beforehand. The whole operation was truly painless. I was conscious
    all the time, but did not understand much of the conversation above my
    head. They spoke in a low voice and the doctor gave only short and
    clear commands. My experience was not at all frightful.

    For about half a day my vision on the right eye was only diffuse
    light. After the vitrectomy the eyeball was filled partly with a
    liquid, partly with air. The refraction of light by air gives a very
    blurred image on the retina. After a day the air bubble had already
    slightly shrunk and I could see normally in the uppermost field of
    vision. The air bubble is of course on top, but as the lens inverts
    the image, it looks as if it were on the bottom. The bubble shrunk
    progressively. After three days the field of vision was sufficient for
    driving. On day 10 the bubble had gone completely.
    I stayed in hospital on the day before and on the day of the
    operation, but could go home the day after. I had to return daily for
    checks on the first few days.
    A concern, which I had from searching the Internet, was that one would
    have to stay and sleep head down for up to 2 weeks. Operation
    techniques seem to have improved tremendously, I did not receive any
    such instruction. I should however not sleep on the back, but on the
    side. For as long as the air bubble was there I should not go to
    altitudes higher than 1200 m (about 4000 feet). Which means I should
    also not travel by air.
    How is the success? The recovery of the retina needs several months.
    At this time the improvement is clear, but not great. There is a clear
    improvement of near-vision, reading in books and on computer screens.
    I can even read font 10 texts again on the computer screen without
    glasses, though not comfortly. Far vision and seeing distorted
    straight lines seems to improve only slowly, but I was told that the
    retina needs time to rearrange itself. I will need new glasses after
    full recovery.
    My conclusion at this time: I am very happy. Anxiety before the
    operation was unfounded. I had the impression I was in caring and
    competent hands at the Lucerne hospital. I guess they use the most up
    to date equipment and are very experienced. I look forward for a great
    hiking season in the Swiss Alps without being afraid of stumbling
    because of bad vision.
    I wish you good luck. Be confident!

    fbuholzer, Mar 29, 2007
  4. macpuckergal

    macpuckergal Guest

    Thank you so much for your response. I hope things go better for you.
    I would appreciate your keeping me posted on how you're doing.
    macpuckergal, Mar 31, 2007
  5. macpuckergal

    macpuckergal Guest

    Thank you so much for the detailed information on your surgery, as
    well as your good wishes! Sorry I'm not in Europe to check out the
    facility and doctor you used. I'm in the Los Angeles area of
    California and a member of Kaiser Permanente medical group. My
    retinologist has excellent training and does a lot of these
    operations, but not as many as your doctor.
    Please keep me informed as to your progress. I'm excited to learn
    about other people's experiences on this Google group. I know of no
    one personally who has gone through this surgery, so this group
    discussion is very helpful. Thanks so much.
    macpuckergal, Mar 31, 2007
  6. macpuckergal

    Jane Guest

    Your surgery and recovery should be painless. Usually it is done with
    local anesthesia and IV sedation. I chose to skip the IV sedation,
    and I actually walked over to my local multiplex that afternoon
    (wearing an eye patch) and stayed for a double feature. (By the way,
    I was able to watch my surgery, because my "block" never reached my
    optic nerve. It was an extremely interesting and hopefully once-in-a-
    lifetime experience, but not for everybody. IV sedation is the norm
    in the US.)

    Do inquire whether the newer 25-gauge "sutureless" vitrectomy
    equipment can be used for your surgery. It should greatly speed up
    your visual recovery. In my case, those horrible sutures were the
    worst part of my recovery experience.

    I don't know how frequently retinally-induced aniseikonia occurs in
    cases of macular pucker, since there is no data about this. My
    surgery was done at a teaching hospital, and the resident I saw on my
    last visit told me that he knew nothing about aniseikonia. (I hope
    this changes if he is going to be seeing retinal patients. I emailed
    a couple of excellent articles on the subject as my contribution to
    his education.) But until retinal specialists become more aware of
    and knowledgeable about this condition, I guess people like me are
    going to have to diagnose and treat themselves using the resources
    available on the internet. (Yes, I'm angry about being forced to
    assume this responsibility.) Dr. David Robins did a good job of
    explaining the etiology of retinally-induced aniseikonia in previous
    posts to this group.
    Jane, Apr 1, 2007
  7. macpuckergal


    Oct 2, 2015
    Likes Received:
    @Franz, I live in Switzerland, Canton Vaud, and I am diagnosed Macular Pucker just a few days ago.
    Now I am trying to find the best availeble eye surgeon witch is so difficult iff youre not familliar with eye surgeons
    Can you please give me the name off youre eye surgeon and exact name off the eye hospital where you had youre operation in Luzerne?
    Thank you so much in advance!
    With kind regards,
    ps so sorry for my English!
    Carola, Oct 4, 2015
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