Abstract
Background
Although macular pucker removal in patients with metamorphopsia due to a macular pucker is a traditional elective vitreoretinal indication, we found that patients were not uniformly satisfied after surgery. We wished to study outcome in vision and metamorphopsia in patients undergoing macular pucker surgery, to assess changes between 1- and 5-year follow-up, as well as patient satisfaction at 5 years.
Methods
We assessed 107 consecutive patients undergoing macular pucker surgery and subsequent cataract surgery when not already pseudophakic. Early Treatment of Diabetes Study (EDTRS) vision and Sine Amsler Chart metamorphopsia grading were assessed before surgery and 1 year postop in 107 patients. In 57 patients we obtained a 5-year vision, metamorphopsia grading and a response to a questionnaire.
Results
After 1 year, mean vision had improved 2 ETDRS lines and metamorphopsia had decreased in 83% of the patients. The 57 patients returning for the 5-year follow-up and questionnaire had a statistically significantly greater improvement in vision at 1 year than those who did not return. In these 57 patients, a further mean increase of 1 ETDRS line had occurred, as well as a further decrease in metamorphopsia in one third of the patients. Forty of 57 patients (70%) indicated that they would elect to have surgery again. Reasons for not returning after 5 years, however, were probably related to dissatisfaction in at least one third of patients.
Conclusions
Although macular pucker surgery resulted in an increase in vision and a decrease of metamorphopsia in 83% of patients after 1 year, we assume, based on the biased patient sample we questioned after 5 years, that subjective assessment would be positive in only a small majority of the patients.
Similar content being viewed by others
References
Arimura E, Matsumoto C, Okuyama S, Takada S, Hashimoto S, Shimomura Y (2005) Retinal contraction and metamorphopsia scores in eyes with idiopathic epiretinal membrane. Invest Ophthalmol Vis Sci 46(8):2961–2966, doi:10.1167/iovs.04-1104
Arndt C, Rebollo O, Seguinet S, Debruyne P, Caputo G (2007) Quantification of metamorphopsia in patients with epiretinal membranes before and after surgery. Graefes Arch Clin Exp Ophthalmol 245(8):1123–1129, doi:10.1007/s00417-006-0505-1
Bouwens MD, Van Meurs JC (2003) Sine Amsler Charts: a new method for the follow-up of metamorphopsia in patients undergoing macular pucker surgery. Graefes Arch Clin Exp Ophthalmol 241(2):89–93, doi:10.1007/s00417-002-0613-5
de Bustros S, Thompson JT, Michels RG, Rice TA, Glaser BM (1988) Vitrectomy for idiopathic epiretinal membranes causing macular pucker. Br J Ophthalmol 72(9):692–695, doi:10.1136/bjo.72.9.692
Geerts L, Pertile G, van de Sompel W, Moreels T, Claes C (2004) Vitrectomy for epiretinal membranes: visual outcome and prognostic criteria. Bull Soc Belge Ophtalmol 293:7–15
Ghazi-Nouri SM, Tranos PG, Rubin GS, Adams ZC, Charteris DG (2006) Visual function and quality of life following vitrectomy and epiretinal membrane peel surgery. Br J Ophthalmol 90(5):559–562, doi:10.1136/bjo.2005.085142
Green WR, Kenyon KR, Michels RG, Gilbert HD (1979) Ultrastructure of epiretinal membranes causing macular pucker after retinal re-attachment surgery. Trans Ophthalmol Soc U K 99(1):65–77
Hirneiss C, Neubauer AS, Gass CA, Reiniger IW, Priglinger SG, Kampik A et al (2007) Visual quality of life after macular hole surgery: outcome and predictive factors. Br J Ophthalmol 91(4):481–484, doi:10.1136/bjo.2006.102376
Hirneiss C, Rombold F, Kampik A, Neubauer AS (2006) Visual quality of life after vitreoretinal surgery for epiretinal membranes. Ophthalmologe 103(2):109–113, doi:10.1007/s00347-005-1252-0
Massin P, Allouch C, Haouchine B, Metge F, Paques M, Tangui L et al (2000) Optical coherence tomography of idiopathic macular epiretinal membranes before and after surgery. Am J Ophthalmol 130(6):732–739, doi:10.1016/S0002-9394(00)00574-2
Massin P, Paques M, Masri H, Haouchine B, Erginay A, Blain P et al (1999) Visual outcome of surgery for epiretinal membranes with macular pseudoholes. Ophthalmology 106(3):580–585, doi:10.1016/S0161-6420(99)90119-7
Matsumoto C, Arimura E, Okuyama S, Takada S, Hashimoto S, Shimomura Y (2003) Quantification of metamorphopsia in patients with epiretinal membranes. Invest Ophthalmol Vis Sci 44(9):4012–4016, doi:10.1167/iovs.03-0117
McCarty DJ, Mukesh BN, Chikani V, Wang JJ, Mitchell P, Taylor HR et al (2005) Prevalence and associations of epiretinal membranes in the visual impairment project. Am J Ophthalmol 140(2):288–294
McDonald HR, Harris MJ (1988) Operating microscope-induced retinal phototoxicity during pars plana vitrectomy. Arch Ophthalmol 106(4):521–523
Michels M, Lewis H, Abrams GW, Han DP, Mieler WF, Neitz J (1992) Macular phototoxicity caused by fiberoptic endoillumination during pars plana vitrectomy. Am J Ophthalmol 114(3):287–296
Michels RG (1984) Vitrectomy for macular pucker. Ophthalmology 91(11):1384–1388
Mitchell P, Smith W, Chey T, Wang JJ, Chang A (1997) Prevalence and associations of epiretinal membranes. The Blue Mountains Eye Study, Australia. Ophthalmology 104(6):1033–1040
Tilanus MA, Cuypers MH, Bemelmans NA, Pinckers AJ (1997) Prognostic value of pattern reversal visual-evoked potentials in idiopathic epiretinal membrane. Graefes Arch Clin Exp Ophthalmol 235(8):474–479, doi:10.1007/BF00947002
Van Den Biesen PR, Berenschot T, Verdaasdonk RM, van Weelden H, van Norren D (2000) Endoillumination during vitrectomy and phototoxicity thresholds. Br J Ophthalmol 84(12):1372–1375, doi:10.1136/bjo.84.12.1372
Van Meurs JC, Mertens DA, Peperkamp E, Post J (1993) Five-year results of vitrectomy and silicone oil in patients with proliferative vitreoretinopathy. Retina 13(4):285–289
Welch JC (1997) Dehydration injury as a possible cause of visual field defect after pars plana vitrectomy for macular hole. Am J Ophthalmol 124(5):698–699
Wimpissinger B, Binder S (2007) Entry-site-related retinal detachment after pars plana vitrectomy. Acta Ophthalmol Scand 85(7):782–785, doi:10.1111/j.1600-0420.2007.00930.x
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Bouwens, M.D., de Jong, F., Mulder, P. et al. Results of macular pucker surgery: 1- and 5-year follow-up. Graefes Arch Clin Exp Ophthalmol 246, 1693–1697 (2008). https://doi.org/10.1007/s00417-008-0909-1
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00417-008-0909-1