Cataract Surgery, Macular Pucker & Scarring

Question: I had Cataract Surgery in May and after the required recovery time, I saw my optometrist to get new lenses. After waiting two weeks for the glasses, I was not able to read at all. My optometrist re-examined me and found that the vision in my right eye was worse than when he had examined me two weeks prior. He noticed scaring in that eye and was concerned at the rapid decline in vision and referred me back to my Cataract Surgeon. Based on my description of my vision and a letter sent from my optometrist, my surgeon said it was most likely opacification and he would just do a YAG procedure, but after examining my eye, he decided to do a Zeiss scan. The scan showed scaring. My Cataract Surgeon then referred me to a Retinal Specialist. They have not called me yet to set up an appointment, but I have some questions in the mean time. My questions are: 1) Where exactly would the scaring be that he saw on the scan? The Retina, Macula or where? 2) Does scaring mean the same thing as opacification? 3) What would the procedure be called to remove the scaring? 4) Approximately how long would the recovery time be before I could order new lenses for my glasses. I also have a Macular Pucker on that eye. I am thinking that the Retinal Specialist possibly would correct the pucker at the same time. 5) If both the scaring and pucker were operated on at the same time, what would the recovery time be? 6) What causes the scaring and how common of a side effect is it?

Answer: It is not possible to provide a great deal of information in your situation as there are a number of key pieces of clinical information that are only found in the examination results-but we will try and help you understand some aspects so that you can ask both the Retina Specialist and Cataract Surgeon the most important questions. From your description is sounds as if there are three possible things going on that are impacting your vision after the Cataract Surgery. First, when the Cataract is removed the "capsule" of the crystalline lens-where the cloudy material existed and formed the Cataract-is left intact. Sometimes this "capsule" becomes opacified and requires a YAG Laser Capsulotomy be performed to create an opening for clear vision. The YAG Laser procedure is a quick, painless laser procdure performed with eye drop anesthesia and improves vision almost immediately. Second, if you have been told that you have a Macular Pucker, this is a condition that is usually unrelated to your Cataract operation but can significantly impact the quality of your "straight ahead" vision-especially for reading. A Macular Pucker does not typically cause scarring. If you are now being diagnosed with "scarring" it is not obvious from your description exactly where that is located. If you also now have scarring of the Macula as if from Macular Degeneration this needs to be reviewed and investigated by the Retina Specialist. If the term "scarring" has been used to describe the opacification of the lens capsule then this will be remediated by the YAG Laser procedure-it is not easy to tell from your description. Your best next step os to schedule that appointment with the Retina Specialist so that the exact conditon of the Retina and Macula can be determined and then if warranted a YAG Laser Capsulotomy can be done.

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