Macular pucker: better to treat early or wait?

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Brief history (carried over from Cataract topic): I'm a 54yo male who developed cataracts in both eyes in 2017. I had them removed and IOLs fitted in 2019, with extremely-good corrective results. However, then due to my age (midst of PVD), pre-IOL myopia, and thin eyewalls, I developed retinal detachments in both eyes, requiring vitrectomy and laser. The recoveries from those (while emotionally taxing) have been successful, with almost no visible impact to one eye, and a bit of a hit to the peripheral vision of the other. Finally, last December, the PCO advanced to the point that YAG was required: this cleared up the PCO in both eyes.

During my nth follow-up visit with the retina specialist this morning, he informed me that I had developed macular pucker in both eyes: one had been there during the last visit, but one is now visible in the other eye. He claims that the current condition is not of clinical concern (or something similar), but that these things often develop over months or years, and that he can perform a surgical procedure at that point to correct.

Doing my background research on the subject, I think that I've determined the following three general insights:

  1. the procedure to remove the scar layer will in general only restore about 50% of what vision has been lost. As such, some doctors recommend the procedure be done sooner rather than later, before the macula "takes a set" and won't flatten back out.
  2. there is a risk of the retinal receptor cells being pulled off when the scar film is removed, resulting in permanent vision loss in the form of gray spots or patches. Since this is the macula, this impacts one's visual acuity more than if it were peripheral.
  3. for some folks, the progression of visual distortion caused by the scarring just stops; for others, it stops and then gets much worse months or years later. For a very small percentage, it reverses. One therefore cannot really tell upfront what to expect down the road.

This is a bit of a dilemma: do I have this done earlier and risk creating (more) permanent dead spots in my vision (this time more in the center), or do I wait to see if it's really needed ... and by that point not very correctable? As much as I'm eager to fill out more "punches" in my "eye surgery punch card" (maybe if I get a few more then they'll give me a free one) and potentially push my luck, I'm really not sure at this point which path makes the most sense. I'm also aware (especially after the cataract and retinal surgeries) that I'm much younger than the average age of the patients that these surgeons regularly see: like with the IOLs, I'll likely be living with the end results a bit longer than someone who's encountering this in their 80s.

What have people's experiences been with this? I'm particularly wondering if (2) above - the retinal receptor cell loss - is a more common issue or if it's more due to the capability of the surgeon.

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