VISUAL FUNCTION AFTER FOVEAL TRANSLOCATION WITH SCLERAL SHORTENING INPATIENTS WITH MYOPIC NEOVASCULAR MACULOPATHY

PURPOSE: To document the visual outcome after successful foveal transl ocation with intentional retinal detachment and scleral shortening for the treatment of myopic neovascular maculopathy. METHODS: Two severel y myopic patients with subfoveal neovascular membranes underwent surgi cal translocation of the fovea to an area of healthy retinal pigment e pithelium by means of scleral shortening and intentional retinal detac h ment. In the postoperative period, monocular and binocular visual fu nction were studied. RESULTS: In one patient, best-corrected visual ac uity improved from 20/150 to 20/20 postoperatively. In the second pati ent, acuity initially improved from 20/70 to 20/30. In both patients, the fixation point shifted from the site of the neovascular membrane. Oblique astigmatism developed and was managed with hard contact lenses , Diplopia and subjective torsion occurred transiently. Micropsia occu rred in one patient, Peripheral fusion assessed by Worth four-dot test ing after resolution of diplopia disclosed suppression in the nondomin ant eye in both cases. CONCLUSIONS: Foveal translocation with intentio nal retinal detachment and scleral shortening was useful in improving visual acuity in two patients with myopic neovascular maculopathy. Dip lopia and aniseikonia occurred but resolved over time as suppression d eveloped. This technique is promising for patients with myopic neo vas cular maculopathy. (C) 1998 by Elsevier Science Inc. All rights reserv ed.