In my opinion, the only thing that Macau and Las Vegas have in common is a lot of casinos. Las Vegas is a place to visit in order to gamble, party, and pretend that any printed money that you don't spend will be taken away from you when you leave. Macau is actually a city, and a fascinating one at that. Depending on where you are, you can feel like you are in Europe (at the beautiful Largo do Senado), China (most of the narrow alleys and apartment buildings), or Las Vegas (inside any casino). And amazingly all of these different parts of Macau are extremely close to each other. So there's plenty to do besides gamble, but of course I have to admit that one of the big reasons I came to Macau was to gamble...or at least to survey the gambling scene.
At this moment, the Wynn Macau is by far the class of the casino field. The recently opened Grand Lisboa has potential (although they might want to fix their blackjack tables that say "Delaer must hit on 16..."), but until all of the construction is done, it will be hard to judge it completely. The Grand Lisboa is looking to replace its neighbor and predecessor, the Casino Lisboa, which has seen better days interior-wise. Meanwhile, construction is continuing on other mega-casinos as well, including an MGM Grand Macau and a Venetian Macau. Obviously these will significantly change the scene, as will the inevitable introduction of poker (and I don't mean Caribbean Stud). Right now, the massively dominant table game is Baccarat. Maybe the Chinese really like James Bond? People also play a decent amount of Sic Bo. I played both those games, but mostly stuck to boring old Blackjack.
The casinos are all situated in an area right on the water, and the big three right now are all very close together (the Sands is actually probably up there as well, but it's a little farther away from the central axis). No 30-minute walks from one casino to the next through massive parking lots like in Las Vegas. The other casinos are of varying quality and mostly resemble those in downtown Las Vegas. Amazingly, one of these that I went into had a "massage" parlor inside! And this wasn't even a really low-level one...
On the whole, I'd like to visit Macau again more as a tourist (especially to see the other islands, Taipa and Coloane) than as a gambler right now, but the simple addition of poker rooms would change my tune. Seeing as Macau has already passed Las Vegas in gambling revenues, it appears as if the sky's the limit...although I hope that they manage to maintain some of the local flavor in the transition from regional gambling hub to worldwide destination.
For the record: After going down big early, I rallied to finish up $150 Hong Kong dollars, which is a shade under $20 U.S.