Macular Pucker: Surgery, Anesthesia, and Recovery Insights

Q: Macular Pucker: Surgery, Anesthesia, and Recovery Insights

Hello Mr. Tsai： 1. General anesthesia is typically used, although a few physicians may opt for local anesthesia. 2. There should be coverage for the procedure, and you should be able to return to work faster than after retinal detachment surgery. 3

Macular fold

Hello, Doctor.
In March of this year, I underwent surgery for retinal detachment.
After the surgery, it was confirmed in June that the retina was successfully reattached.
However, during a follow-up examination, I was found to have a macular fold.
As a result, I had cataract surgery with the implantation of an artificial lens in July.
Since then, my vision has remained at 0.1, with distortion and objects appearing to be obscured in front of me, and I find it difficult to see in dim light.
I would like to ask the following questions:
1.
For the surgery to address the macular fold, will general anesthesia be required, or can it be done with local anesthesia?
2.
Is the surgery covered by health insurance? How long after the surgery can I return to work?
3.
Is there a risk of causing retinal detachment again after the surgery? Thank you for your answers, Doctor.

Cai Xiansheng, 50~59 year old female. Ask Date: 2020/09/05

Dr. Gao Pilin reply Ophthalmology

Hello Mr.
Tsai:
1.
General anesthesia is typically used, although a few physicians may opt for local anesthesia.

2.
There should be coverage for the procedure, and you should be able to return to work faster than after retinal detachment surgery.

3.
Surgery for macular pucker should not cause retinal detachment.
However, since you have had a detachment in the past, the risks may need to be evaluated.

The ophthalmology department at Puzi Hospital in Taiwan is available:
Monday, Tuesday, Thursday, and Friday from 8:00 AM to 12:00 PM, and Wednesday from 2:00 PM to 4:30 PM.

Please note that online responses are for reference only; it is essential to seek medical care at a healthcare facility if necessary.
I hope to have the opportunity to assist you.

Best regards,
Gao Pilin

Reply Date: 2020/09/05

More Info

Understanding macular pucker, also known as epiretinal membrane, is crucial for patients who have undergone retinal surgery, especially after complications like retinal detachment. Your situation, having had a retinal detachment followed by cataract surgery, is not uncommon, and the symptoms you describe—distorted vision, darkening of light, and a significant reduction in visual acuity—are often associated with macular pucker.

1. Anesthesia for Macular Pucker Surgery: The surgery to remove the epiretinal membrane typically does not require general anesthesia. Most ophthalmic surgeons prefer to use local anesthesia, often in the form of an injection around the eye, combined with sedation to keep you comfortable during the procedure. This approach minimizes the risks associated with general anesthesia and allows for a quicker recovery. The local anesthesia will numb the eye, and you will be awake but relaxed during the surgery.

2. Insurance Coverage: In terms of insurance coverage, most health insurance plans, including Medicare, generally cover the surgery for macular pucker if it significantly affects your vision and quality of life. It’s essential to check with your specific insurance provider to understand the details of your coverage, including any copays or deductibles that may apply. Your ophthalmologist's office can often assist with this process by providing necessary documentation and coding for the procedure.

3. Recovery Time and Return to Work: Recovery from macular pucker surgery can vary from person to person. Generally, patients are advised to take it easy for a few days post-surgery, but many can return to light activities within a week. Full recovery, where vision stabilizes and improves, can take several weeks to months. It’s crucial to follow your surgeon's post-operative care instructions, which may include avoiding strenuous activities and keeping your head in a certain position for a few days.

4. Risk of Retinal Detachment: After any eye surgery, including the removal of a macular pucker, there is a small risk of developing complications such as retinal detachment. However, the risk is generally low, especially if the surgery is performed by an experienced surgeon. Your ophthalmologist will monitor your eyes closely post-surgery to catch any potential issues early. It’s essential to report any sudden changes in vision, flashes of light, or new floaters to your doctor immediately.

In summary, macular pucker surgery is a common procedure that can significantly improve visual function for those affected. Local anesthesia is typically sufficient, and most insurance plans cover the procedure if it impacts your vision. Recovery varies, but many patients return to normal activities within a week, while full visual recovery may take longer. Always consult with your ophthalmologist for personalized advice and to address any concerns you may have regarding your specific situation.

Similar Q&A

Timing for Macular Pucker Surgery: Key Considerations and Insights

Dear Director, I am 40 years old. In June 2018, I was diagnosed with macular folds in my left eye at a teaching hospital. My attending physician recommended a vitrectomy combined with the removal of the epiretinal membrane. At that time, I was afraid of undergoing surgery, so I ...

Dr. Gao Pilin reply Ophthalmology
Hello Mr. Fang: 1. The presence of sequelae depends on whether the surgery was successful. If the surgery goes well, there should be no sequelae. If there are any other sequelae, the attending physician will discuss them with you in detail before the procedure. 2. There is not ...

Understanding Anesthesia Options for Macular Pucker Surgery: Full vs. Local

I am scheduled to undergo macular pucker surgery on July 10th, and the hospital has informed me that general anesthesia will be required. I would like to ask the following questions: 1. A friend of mine mentioned that he only had local anesthesia for his macular detachment surg...

Dr. Gao Pilin reply Ophthalmology
Hello: 1. Macular fold surgery typically requires general anesthesia. General anesthesia is a method that renders you completely unconscious and in a pain-free sleep state. During the surgery, you will be in a comatose state and unable to feel pain. General anesthesia provides be...

Post-Surgery Recovery for Macular Pucker: What to Expect

Hello Director He: I underwent macular pucker surgery on my left eye on August 25. I have been sleeping on my stomach for two weeks post-surgery, but as of now (September 13), my vision in the left eye is still very blurry, and I can only see objects about 10 centimeters away, bu...

Dr. He Jianxian reply Ophthalmology
Based on your description, it is possible that the air injected into the eye has not completely dissipated. Vision may gradually improve only after it has fully disappeared. However, the duration for a more complete recovery can vary significantly from person to person. Dr. Ho Ch...

Understanding Multiple Retinal Detachment Surgeries and Recovery Challenges

Hello Dr. Liang, I have a vision of 575 in my left eye and 525 in my right eye, and I am 38 years old. On June 21, I was referred from a clinic to a regional hospital due to a retinal detachment in my left eye (extending to the macula). That afternoon, I underwent a retinal deta...

Dr. Liang Ce reply Ophthalmology
Recommendations: 1. Discuss the above situation further with your attending physician. 2. Alternatively, seek consultation at another ophthalmology medical facility. Thank you. Wishing you good health!