MACULAR SURGERY

Modern surgery of the macula exists since 1965, and was initially prop osed in membrane removal from patients presenting an idiopathic epiret inal membrane. This first indication authorized the development of mac ular microsurgical instrumentation and further analysis of membrane fr agments. However, the exact pathogenesis of these membranes remains ye t unknown. Since 1991 macular surgery was applied in the treatment of macular holes. Results obtained after macular hole surgery confirmed p athogenic hypothesis observed clinically by Gass. Considerable improve ment was therefore acheived in anatomical and functional outcome. Chor ioretinal adhesion agents were recently proposed to optimize the closu re of macular holes. Submacular surgery is the latest technologic ache ivement under investigation. The ultimate indications are age-related macular degeneration, first cause of blindness in industrialized count ries. Retinal transplantation opens new avenues in the treatment of a large number of chorioretinal diseases, The assessement of macular sur gery could pave the way in realising such technical advances.