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Can Cataract Surgery Make a Macular Pucker Worse?

Cataract surgery is the most commonly performed surgical procedure in the UK. As such, it is associated with extremely successful and satisfactory results as well as a low risk profile. However, we understand that awaiting any kind of surgical procedure can be daunting and it is only natural to want to be as informed as possible about the process and any potential risks.

That’s why we decided to cover everything you need to know about Cataract Surgery. For more information, take a look at our ‘Cataract Surgery‘ category page to explore more topics. In this article, we’re taking a look at macular pucker and answering the question: Can Cataract Surgery Make Macular Pucker Worse?

Before we get into Cataract Surgery, let’s cover Macular Pucker – what is it and how does it affect your eyes?

What is a Macular Pucker?

A macular pucker is the wrinkling of the retina caused by scar tissue. This scar tissue may also be referred to as epiretinal membrane (ERM) or cellophane maculopathy. The retina is located at the back of the eye and is made up of millions of nerve cells that react to light refracted through the pupil and cornea.

The macula is a small part of the retina where these light-sensing cells come together. Due to the area affected, a macular pucker can sometimes cause distortions to your vision, though this is not always the case.

Macular pucker is a relatively common disorder with a prevalence of 4% to 18.5% and older people more likely to be affected. There are several known causes of macular pucker, including:

  • Tears in the retina
  • History of retinal detachment
  • Prior eye surgery
  • Eye trauma
  • Infection
  • Diabetes-related retina disease
  • Eye inflammation

What are the symptoms of macular pucker?

While macular pucker is not always associated with poor vision, the main symptom of the disorder is distorted central vision which can cause straight lines – such as sentences in a book – to appear wavy. This type of distorted vision is called “metamorphosis”.

But there are a number of other symptoms to be aware of, including reduced quality vision, double vision, or the image from one eye appearing larger than that from the other. In rare cases, a macular pucker can cause significant vision loss and can lead to a related condition called a macular hole.

However, in most cases, changes to vision are mild and/or get worse slowly and many people are able to adjust. However, it is important to talk to your eye doctor as soon as you notice any changes to your vision. Macular pucker usually only affects one eye. But if a patient does have it in both eyes, one eye is usually worse.

Cataract Surgery and Macular Pucker

So, let’s get back to Cataract Surgery: What does it have to do with macular pucker? Can it make a macular pucker worse? Let’s find out.

Cataract Surgery is the only solution to cataracts. It is primarily performed to remove the cataract-affected lenses from the eye, replacing them with artificial intraocular lenses (IOLs). Like macular pucker, age is the most significant risk factor for the development of cataracts.

Importantly, cataracts do not cause macular puckers. However, as the effects of macular puckers are often quite subtle, vision loss caused by the cataract may conceal any changes to vision. Therefore, patients may not notice them until a cataract is removed. But what about Cataract Surgery?

As we mentioned earlier, a macular pucker may sometimes be associated with intraocular inflammation. It is therefore possible that unusual inflammation following Cataract Surgery may be linked to the growth of a macular pucker.

The findings of one study also found that cataract patients who also had a macular pucker experienced higher rates of cystoid macular edema (CME) and lower post-operative gains in visual acuity. Nonetheless, the study concluded that “individuals with ERM and VA worse than 20/40 may benefit more from cataract surgery than those with better preoperative VA.”

If you have any further questions about the outcomes and risks of Cataract Surgery, don’t hesitate to get in touch with one of our friendly clinic coordinators. Alternatively, if you’re interested in Cataract Surgery at London Vision Clinic, Book a Consultation today.