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Macular pucker following retinal detachment surgery.

Macular pucker describes minute radiating retinal folds and a preretinal membrane in the macular area. Most often, it follows retinal detachment surgery. A comparison between 105 affected eyes with 3,417 eyes without macular pucker after retina surgery indicates that the following factors probably precipitate macular pucker: vitreous blood, total retinal detachment, detachment of the macula, multiple retina operations, multiple perforations, and most significant, loss of formed vitreous at operation. Diathermy, photocoagulation, or cryoapplication may also be precipitating factors. In affected eyes visual acuity rarely improves as expected particularly if preoperative vision exceeded 20/70. Eyes with 20/400 or better when the diagnosis is made have a 40% chance of later improvement. Eyes with 20/100 or better at the time of diagnosis have a 60% chance of improvement. A possible pathogenesis of preretinal membranes is discussed.