Foveal relocation by redistribution of the neurosensory retina

Aim-To describe a new surgical technique for foveal relocation, and to repo rt the outcome in nine patients treated with this procedure. Methods-Nine consecutive patients with subfoveal choroidal neovascular memb ranes (CNVMs) secondary to age related macular degeneration underwent fovea l relocation surgery by redistribution of the neurosensory retina (RNR). Th e technique involved induction of a retinal detachment via a single retinot omy, relocation of the fovea by "sweeppng" the retinal tissue with a retina l brush, and stabilisation of the retina in its new location using perfluor ocarbon liquid peroperatively and silicone oil postoperatively. Results-In eight of nine eyes successful relocation of the fovea was achiev ed; in one eye the CNVM remained in a subfoveal location postoperatively. V isual acuity improved in two eyes, remained unchanged in three, and decreas ed in four eyes after a median follow up of 4 months (range 2.5-6 months). Complications included rupture of a foveal cyst with the development of a m acular hole in one eye and epimacular membrane formation in another eye. In two eyes, macular retinal vessel closure occurred at the time of laser pho tocoagulation; one of these eyes later developed cystoid macular oedema and the other an epiretinal membrane. Recurrence of the CNVM was observed in o ne eye, but was controlled with further laser treatment. Conclusions-Foveal relocation by RNR appears to be feasible, obviating the need for extensive retinotomies or scleral shortening.