Purpose: Macular pucker patients were re-examined 16-90 months after s
urgery (mean 72 months) to evaluate visual acuity, metamorphopsia, and
complications, with particular reference to cataract development. Sur
gery had been performed on 48 eyes in 46 patients, 31 eyes having a pr
imary, and 17 eyes a secondary macular pucker. Results: At the 6-month
control 65% of the eyes with a primary macular pucker and 35% of the
eyes with a secondary macular pucker exhibited an improved visual acui
ty defined as doubling or more of the visual angle. At the last contro
l 57% of the primary group and 33% of the secondary group had a visual
acuity which still exceeded the preoperative value. At the final exam
ination a cataract progression was observed in 22/28 (79%) of the prim
ary group and 8/14 (57%) of the secondary group, In the primary group
11% and in the secondary group 36% of the eyes suffered a retinal deta
chment. All cases were successfully treated and none were followed by
visual deterioration. Conclusion: The improvement in visual quality af
ter macular pucker surgery appears to be long-standing, if not permane
nt, especially in primary cases. In those eyes in which a decrease in
visual acuity is observed, the most frequent cause is cataract develop
ment.