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V.A.2. Vitreomaculopathy Surgery

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Vitreous

Abstract

Macular pucker results from a premacular membrane often referred to erroneously as an “epiretinal” membrane. The term “epi” means adjacent to, which could be subretinal. Furthermore, the membranes in question are attached to the macula; thus the term “premacular” is more precise for two reasons. This premacular membrane is a fibrocellular proliferation that grows on the internal limiting membrane of the macula [see chapter III.F. Vitreous in the pathobiology of macular pucker]. Premacular membrane contraction leads to progressive distortion of the macular structure, producing visual acuity loss and metamorphopsia (Figure V.A.2-1). Vitrectomy with membrane peeling has been shown to release the traction exerted on the macula, with an improvement in visual acuity and metamorphopsia. Since macular pucker is a very frequent pathology [1] that often progresses slowly, the optimum time for surgery remains unclear. Furthermore, in some cases in spite of an adequate removal of the premacular membrane, visual outcomes are unsatisfactory. In the last few years, several reports have focused on the prognostic factors that may help to determine when to recommend surgery to a specific patient.

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Authors and Affiliations

  1. Department of Ophthalmology, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigaciones Sanitarias (IRYCIS), Madrid, Spain

    Marta S. Figueroa MD, PhD & Inés Contreras MD, PhD

  2. Vissum Madrid, Madrid, Spain

    Marta S. Figueroa MD, PhD

  3. Clínica Rementería, Madrid, Spain

    Inés Contreras MD, PhD

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  1. Marta S. Figueroa MD, PhD
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  2. Inés Contreras MD, PhD
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Correspondence to Marta S. Figueroa MD, PhD .

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Editors and Affiliations

  1. VMR Institute for Vitreous Macula Retina, Huntington Beach, California, USA

    J. Sebag

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Figueroa, M.S., Contreras, I. (2014). V.A.2. Vitreomaculopathy Surgery. In: Sebag, J. (eds) Vitreous. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1086-1_33

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