Incidence and Characteristics of Macular Pucker Formation After Primary Retinal Detachment Repair by Pars Plana Vitrectomy Alone

Abstract

To evaluate postoperative macular pucker formation in patients who underwent pars plana vitrectomy (PPV) for repair of primary rhegmatogenous retinal detachment (RD). A retrospective, observational case series of 141 consecutive patients who underwent primary RD repair by PPV alone was performed. Patient charts were selected based on coding searches of a database from May 1, 2002, to December 31, 2003, in a large retina referral practice. Patients with a history of retinal surgery, silicone oil tamponade, or another visually significant ocular condition were excluded. Of 141 patients, 18 (12.8%) were noted to have a postoperative epiretinal membrane at clinical examination. Of 18 patients, 6 (33.3%) underwent a second vitrectomy procedure with membrane peeling for macular pucker removal. The mean time from RD surgery to membrane peeling surgery was 5.4 months. The average improvement in vision after repeated surgery was 5.6 Snellen chart lines. In our series, 12.8% of patients who underwent repair of a primary RD by PPV alone developed a postoperative macular pucker. Overall, the 4.3% of patients who underwent repeated surgery for removal of macular epiretinal membranes benefited with visual acuity improvement.