This pleasant 42-year old man has noticed his vision is changing now that the bubble is gone, but he is starting to notice distortion of central vision. He had a giant retinal tear retinal detachment repair emergently done on November 8, 2007, and subsequent laser on November 15th. VISUAL ACUITY: Vision OD 20/400. IOP: OD 8. There is 1+ nuclear sclerosis OD: Vertical C/D ratio is 0.1. There is 4+ epiretinal membrane. The retina is attached repaired by laser around the superotemporal detachment there is a moderate buckle. IMPRESSION: 1. POST RETINAL DETACHMENT REPAIR OF MACULAR PUCKER - RIGHT EYE 1. STATUS POST REPAIR OF GIANT RETINAL TEAR/RETINAL DETACHMENT - RIGHT EYE DISCUSSION: I explained to the patient that unfortunately he does have a macular pucker now. These post retinal detachment repair and macular puckers respond favorably to surgery and I suggested we do the surgery sooner than later because I am worried that the pucker may advance to the point where it actually re-detaches the retina. I have scheduled him for surgery within the next few weeks. I will keep you abreast of his progress vision was 20/40 6 weeks post-op. See images pre and post op.