Results of macular pucker surgery: 1- and 5-year follow-up.
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.
Bouwens
M Dimitri
MD
Vitreoretinal Department, The Rotterdam Eye Hospital, Schiedamsevest 180, 3011 BH, Rotterdam, The Netherlands.
de Jong
Floris
F
Mulder
Paul
P
van Meurs
Jan C
JC
D000368:Aged; D000704:Analysis of Variance; D002387:Cataract Extraction; D019773:Epiretinal Membrane / Q000150:complications* / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008266:Macula Lutea / Q000601:surgery*; D008297:Male; D017060:Patient Satisfaction; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014786:Vision Disorders / Q000209:etiology* / Q000503:physiopathology; D014785:Vision, Ocular