Yes, a macular pucker (aka epiretinal membrane or ERM) could affect your night driving ability. In most cases, acuity doesn't get worse over time because of the pucker. However, recent research shows that visual outcomes are significantly better when surgery to peel the ERM is done sooner rather than later. (There is some evidence that delaying surgery may result in irreversible damage to the macula.) You would want this type of surgery to be performed by the most experienced retinal specialist in town. If you can travel for surgery, consider seeing Dr. Steve Charles in Memphis. His website has good information about this condition. (Try googling)
what are the other options you refer to?
Dear golfadkt,
It does sound as if you might have a number of different issues with your eyes including the following: crystalens implants, small refractive error, macular pucker, dry eyes and rosacea. All of these may be contributing to your vision issues and it is important to sort out how much each contributes. The first and foremost issue is your nighttime driving vision. For this, your eyeMD might want to prescribe an eyedrop, known as alphagan to assist you. Please ask him or her if this is an option. It is important to note that all intraocular lens implants do cause some glare and halo and some people are bothered by this while driving at night. There are other possible treatments as well which might be beneficial for this.
Dr. Feldman
Sandy T. Feldman, M.D., M.S.
ClearView Eye and Laser Medical Center
San Diego, California