Macular Translocation With 360° Retinotomy for Exudative Age-Related Macular Degeneration

Abstract

Background: Macular rotation surgery comprises surgical extraction of choroidal neovascular membranes in age-related macular degeneration (AMD) and translocation of the foveal neural retina over adjacent retinal pigment epithelium.Objective: To determine whether macular translocation with 360°retinotomy can stabilize and/or improve visual acuity in patients with subfoveal choroidal neovascularization (CNV) secondary to AMD.Design: This study consisted of a standardized surgical procedure on a series of 90 consecutive patients and follow-up examinations at fixed intervals for 12 months.Participants: All patients in this study had experienced recent visual loss resulting from subfoveal CNV caused by AMD. Twenty-six patients had major macular subretinal hemorrhage, 39 patients had occult subfoveal CNV, and 25 patients had classic subfoveal CNV.Methods: Macular translocation surgery was performed between 1997 and 1999. The patients were examined preoperatively and at 3, 6, and 12 months postoperatively, including visual acuity, microperimetry, angiography, and orthoptic assessment.Results: Visual acuity increased by 15 or more letters in 24 patients, remained stable in 37 patients, and deteriorated by 15 or more letters in 29 patients at 12 months postoperatively. A secondary procedure was necessary in 17 patients because of severe complications; proliferative vitreoretinopathy was observed in 17 eyes, macular pucker in 5 eyes, and macular hole in 1 patient. Conclusion:Macular translocation is a technically demanding surgical procedure. Although the procedure has a high rate of surgical and postoperative complications, the functional and anatomical results appear to be promising for selected patients with subfoveal CNV secondary to AMD.

Visual function 5 years or more after macular translocation surgery for myopic choroidal neovascularisation and age-related macular degeneration

“…9,11,12,[15][16][17][18][19][20] Our findings are consistent with these reports, and our Eye results for the 35 AMD eyes showed that the mean BCVA improved from 1.128 ± 0.075 to 0.724 ± 0.049 logMAR units at 12 months and did not worsen at the final examination even after follow-up periods of Z5 years.…”

“…[5][6][7] This technique involves the detachment of the entire retina from the RPE by a subretinal infusion of fluid followed by an axial rotation of the macula. [8][9][10][11][12] Although this surgery improves the VA after 1 to 2 years, 8,9,11,[13][14][15] it is rarely performed now because of the difficult surgical procedures and the production of severe strabismus. However, the long-term results of this surgery have provided important information on whether an impaired sensory retina moved onto healthy RPE can recover and maintain good visual function for long periods.…”

“…Most studies have reported favourable outcomes but for follow-up periods of r2 years after the surgery. 9,11,12,[15][16][17][18][19][20] On the other hand, there are two reports on the visual outcome of macular translocation surgery with follow-up periods of Z3 years, 21,22 and the visual outcomes were reported to be poor in both. However, in these two reports, the visual improvement was not attained even in the first year.…”

A Study on Proliferation and Behavior of Retinal Pigment Epithelial Cells on Purified Alginate Films

“…There exist the methods of transplantation of RPE cells, one is suspension, 10∼15 cells, form a monolayer when transplanted to the subretinal space and the other one is cultivating the RPE cells on the scaffold (18)(19)(20)(21). Above them, using the former method to transplanted RPE cells causes the fibrosis at the subretinal space along with the formation of the RPE of the multilayer (22).…”

Full macular translocation following photodynamic therapy in neovascular age-related macular degeneration

“…[3][4][5][6][7][8][9] The purpose of this retrospective case study is to elucidate the long-term functional and morphological outcome of PDT-nonresponders who had undergone FMT in neovascular AMD.…”