Macular Pucker

Macular pucker, also known as epiretinal membrane or cellophane membrane, is a condition that is usually a result of the physical changes that come with aging. It occurs when the vitreous gel comes in contact with the retina. There are other, much less common causes of macular pucker, but generally it is simply the result of the aging process.

Macular pucker causes a distortion or blurring of central, focused vision. Peripheral vision is usually not affected at all. Although there may be occasionally other symptoms, such as floaters, it is the distortion and blurring which is most troublesome to patients. This distortion of vision is the result of a fine layer of scar tissue cells which have formed on the surface of the retina and cause it to wrinkle, much like ripples or creases in wallpaper on a smooth wall. Usually the vision is not severely affected and it often occurs in just one eye. Macular pucker tends not to be a progressive problem.

Patients with a fairly severe macular pucker may choose surgery, which is the only known treatment option for this problem. The surgery is called a vitrectomy and consists of removing the vitreous gel and scar tissue, which cause the wrinkling. The surgery generally takes less than one hour, can be done under local or general anesthesia and is usually done as a same-day surgery. After the surgery, the eye is somewhat irritated, but this resolves by the time the patient can resume normal activities ­ often in a few days.

The benefit of surgery to repair a macular pucker is hard to predict. Some patients notice a prompt, significant improvement in their vision. Others may experience only a minimal improvement. The recovery of vision may take as long as six to twelve months. In general, a "fresh" pucker will improve more dramatically than one that has existed for some time.

As with any type of surgery, there are risks associated with surgery to repair macular pucker. Complications are infrequent, but do occur and include serious problems like retinal detachment, hemorrhage and infection. These complications could cause a severe loss of vision. Persons who have had macular pucker repair are at increased risk for developing a cataract.