MACULAR PUCKER AFTER RETINAL-DETACHMENT S URGERY

Purpose To report the prevalence and visual outcome of macular pucker occurring after retinal detachment surgery, and to analyze its risk fa ctors. Methods We retrospectively studied 865 cases of retinal detachm ent that had been successfully treated in the absence of macular hole or proliferative vitreoretinopathy higher than grade C1. For the stati stical analysis, 63 variables were submitted to CHI-square test. Resul ts Macular pucker occurred in 68 cases (7.7%). Final visual acuity was 0.5 or better in 24 cases, spontaneously in 7 and after macular surge ry in 17. In 6 other cases, macular pucker was much less important in terms of visual impairment than coexisting amblyopia or other posterio r pole pathology. In the 38 remaining cases, macular pucker was the ca use of visual failure, despite macular surgery in 9 of them. Retinal d etachment recurred after macular surgery in 2/26 cases. Nine variables were found to correlate with an increased risk of macular pucker: emm etropia, hyperopia, preoperative acuity reduced to light perception-ha nd movement, macula off, preoperative proliferative vitreoretinopathy (grade B or C1), retinal tears up to 30 degrees, retinal tears larger than 30 degrees, and cumulative retinal break area larger than 3 disks . Conclusion Our result show that macular surgery can be useful in cas e of macular pucker after retinal detachment surgery. They also sugges t that macular pucker and proliferative vitreoretinopathy have some ri sk factors in common.