VISUAL RESULTS AFTER SURGICAL REMOVAL OF SUBFOVEAL CHOROIDAL NEOVASCULAR MEMBRANES

Purpose: The authors report their experience with the surgical removal of subfoveal choroidal neovascularization. Correlations between preop erative characteristics and final postoperative visual acuity are expl ored. Methods: A retrospective study of 159 consecutive patients was p erformed between February 1990 and August 1993. Follow-up of 2 or more months was available for 147 eyes: presumed ocular histoplasmosis syn drome, 67 eyes; age-related macular degeneration, 41 eyes; myopia, 10 eyes; multifocal choroiditis, 9 eyes; idiopathic, 8 eyes; angioid stre aks, 4 eyes; and miscellaneous, 8 eyes. Results: Sixty-seven eyes had presumed ocular histoplasmosis syndrome: mean follow-up was 10.5 month s. Visual acuity was stable or improved in 56 (83%) eyes and 20/40 or greater in 21 (31%) eyes. Mean interval to best visual acuity was 3 mo nths. A recurrence rate of 37% had no significant effect on final visu al outcome (P = 0.952). Forty-one eyes had age-related macular degener ation: mean follow-up was 15 months. Visual acuity was improved in onl y five (12%) eyes and was 20/40 or greater in only two (5%) eyes. The interval to best visual acuity was 5 months. A recurrence rate of 27% had no significant effect on final visual outcome (P = 0.31). The visu al results and recurrence rates for eyes with less common disorders ar e presented. Conclusion: The surgical excision of subfoveal choroidal neovascularization may stabilize or improve visual acuity in selected cases. Patients with focal disorders of the retinal pigment epithelium -Bruch's membrane complex appear to have a better surgical outcome tha n those with diffuse disease.