Macular Pucker surgery (Vitrectomy & peel) should I have it?

[Devoted Daughter]

Last fall/winter I began to notice changes in my vision that became increasingly annoying.  I am 57 years old so I thought it was typical changes and that I needed a new prescription for my eyeglasses.  I saw an optometrist who informed me I needed to see a retinal specialist.

Some background: I had an injury to my right eye about 5 years ago which caused the vitreous to pull away from the retina.  I had eye care but there was no tear or damage to the retina at the time and I did not need any treatment.  I have macular pucker in both eyes but it is much worse in the right eye.

I went to see a retino-vitreal specialist 3 months ago and he did not recommend surgery at the time because I had 20/20 vision with my glasses and just some mild distortion which gets worse when I am fatigued.  He recommended that I get checked again in 3 months to check to see if the situation stabilized.

I returned last week for followup and my condition has deteriorated a little.   My vision is correctable to 20/30 with my glasses now and I continue to struggle to enjoy clear vision intermittently.

The surgeon is concerned that with the rate of change that I should have surgery a bit sooner than waiting another 3-6 months.  

I have an appointment for a second opinion but I hoped to get some feedback from others about waiting longer to see what happens.

Will it hurt me to wait?  I am very concerned about the risks inherent with this surgery.  Maybe doing nothing is better than risking more injury to the eye?

Thanks!

[JohnHaganMD]

=

[JohnHaganMD]

Thanks for the information

[JohnHaganMD]

Getting a second opinion from another retina surgeon is a good idea. 20/30 is still pretty good vision and as a generalization surgery is usually not done until vision is about 20/60 or worse. It is major surgery with major possible complications. It almost always makes cataracts develop/grow faster so you likely will need cataract surgery in a couple of years.  Do not smoke, keep your blood pressure, blood sugars and body weight in normal range as these can make grow faster.

[Devoted Daughter]

Update:  I went for a second opinion and the surgeon confirmed that I should have the surgery.  In addition to the OCT, I had fluorescein angiography done as part of this surgeon's routine exam.  Results revealed mild cystoid macular edema.  He recommended a course of steroid drops prior to surgery to reduce inflammation.  He also took the time to show me my fluorescein pictures and to discuss what they meant.  He also explained exactly what he would do if he operated on me.

This was much more than I got from the first doctor.  There were many other factors that helped me to make the decision to go with surgeon #2.  

I had surgery on Thursday and the next day when the patch was removed my vision was 20/40.  I expect that this will improve even more as my eye heals.

I'll update again in time.

[MrPresley]

Glad to hear your surgery went well, and the surgeon you went to for the 2nd opinion sounds a lot like the ophthalmologist I was referred to by my optometrist.

I had the vitrectomy/ERM peel procedure done almost one year ago now and no complications to report other than the expected cataract development that Dr. Hagan mentioned.