SURGICAL REMOVAL OF SUBFOVEAL IATROGENIC CHOROIDAL NEOVASCULAR MEMBRANES

Objective: To present the cases of two patients with laser-induced iat rogenic subfoveal choroidal neovascular membranes (CNVMs) who underwen t surgical removal of the membranes with favorable outcomes. Design: i nterventional case reports. Participants: Two patients with iatrogenic subfoveal CNVM. One case developed after laser treatment for macular edema due to branch retinal vein occlusion, and the second case develo ped after focal laser photocoagulation for diabetic retinopathy. Inter vention: Surgical removal by pars plana vitrectomy. Main Outcome Measu rer Visual acuity, scotoma, retinal examination with fundus photograph y, and fluorescein angiography before surgery and during the postopera tive period. Results: Both patients underwent surgical removal after p rogression of the membrane with severe visual loss of 20/200 was noted . At present follow-up, there is a significant improvement in visual a cuity and a reduction in the size of the scotoma. No recurrence of CNV M is noted. Conclusion: Both patients with laser-induced iatrogenic su bfoveal CNVM achieved a good visual outcome after surgical removal of the membrane. The reasons for a good surgical result are thought to be twofold. First, the origin of the CNVM is extrafoveal at the site of laser application. The chance for foveal cone cell damage during the s urgery is reduced. Second, the degree of cellular destruction in iatro genic CNVM is usually focal without extensive retinal photoreceptor ce ll and retinal pigment epithelial damage. Therefore, a better chance o f postoperative visual recovery is anticipated.