This is often called ‘macular pucker’. Essentially, it’s scar tissue that can grow on the central, sensitive part of the retina. The membrane becomes thicker, wrinkling the retina. This, in turn, causes vision to become distorted.
The central vision is distorted due to a fine layer of scar tissue on the surface of the retina.
A fine layer of fibrous scar tissue can deposit on the surface of the retina in association with many ocular conditions, but most often occurs in an otherwise normal eye. With time the scar tissue increasingly contracts and distorts the retina. This damages the central vision and can lead to permanent loss of central vision if neglected.
Vitrectomy surgery and peeling of this fine layer of scar tissue will relieve the traction on the retina and decrease the visual distortion. The surgery can be performed under local anaesthesia or general anaesthesia, depending on the patient and anaesthetist’s choice. If performed under local anaesthesia, the patient will be required to stay still for approximately one hour during surgery.
The surgery can be performed as a day case or an overnight stay can be arranged. Usually, an intraocular gas bubble is infused into the eye and the patient would be asked to posture face-down on a bed (at home) for 30 minutes out of every waking hour for a few days (exact time depends on the amount of traction). During the period of a week or so whilst the gas bubble is temporarily present, the vision will be poor.
With removal of the contractile fibrotic scar tissue, the retinal distortion decreases and so does visual distortion, and the visual acuity improves
In those patients who have not already had cataract surgery, patients will develop a cataract after vitrectomy surgery. This will require cataract extraction. A retinal tear is a rare complication (5%), and this is searched for and treated at the time of surgery with laser. It is very rare for a treated tear to cause problems, but if a tear does not adequately seal, it can result in a retinal detachment, which can decrease vision and require further surgery. Complications that can occur in any intraocular surgery such as haemorrhage and infection are extremely rare (1 in 5000). Following complete re-absorption of the gas bubble, vision will start to return, usually after 1-2 weeks.
Dr Bourke explains the condition called epiretinal membrane, as well as outlining treatments for it.
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