Limited inferior macular translocation for the treatment of subfoveal choroidal neovascularization secondary to age-related macular degeneration

PURPOSE: To review a series of patients with age-related macular degenerati on undergoing limited macular translocation for the treatment of subfoveal choroidal neovascularization, to determine short-term visual acuity outcome s, to measure amounts of attainable retinal movement, and to identify progn ostic factors. METHODS: A retrospective review was conducted on a consecutive series of pa tients undergoing inferior limited macular translocation with scleral imbri cation for the treatment of subfoveal choroidal neovascularization secondar y to age-related macular degeneration. The main outcome measures investigat ed were distance of macular translocation, visual acuity at 3 and 6 months after surgery, change in visual acuity from baseline, and the development o f intraoperative and postoperative complications. Univariate and multivaria te analyses of a number of potential prognostic factors were undertaken. RESULTS: Macular translocation was achieved in all 102 eyes (101 patients) included in this study. The range of movement varied from 200 to 2,800 pm w ith a median movement of 1,200 mu m Nearly 33% of the study group achieved a visual acuity better than 20/100 at 3 months, and 49% achieved this visio n at 6 months. At 3 and 6 months, 37% and 48% of the study group, respectiv ely, experienced 2 or more lines of improvement on visual acuity testing, a nd by 6 months 16% experienced greater than 6 lines of visual improvement. Good baseline vision, achieving the desired amount of macular translocation , a greater amount of macular translocation, and recurrent choroidal neovas cularization at baseline were associated with better visual acuities at 3 a nd 6 months. Poor preoperative vision and the development of complications were associated with worse vision at 3 and 6 months. CONCLUSIONS: Limited macular translocation is a technically feasible proced ure that can lead to significant visual improvement and good visual acuity in some patients presenting with subfoveal choroidal neovascularization ass ociated with age-related macular degeneration. A randomized prospective cli nical trial of this surgical technique is warranted. (C) 2000 by Elsevier S cience Inc. All rights reserved.