Complications associated with limited macular translocation

PURPOSE: To report the ocular complications associated with the limited mac ular translocation procedure. METHODS: Retrospective review of 153 consecutive eyes of 151 patients that had the limited macular trans location procedure for subfoveal choroidal ne ovascularization between April 1996 and February 1999. The major study vari ables investigated included the incidence of specific ocular complications and their impact on visual acuity at 3 months after the surgery. In additio n, baseline patient characteristics and operative factors were evaluated to determine whether they were significant risk factors for the development o f an ocular complication. The existence of a surgical procedure learning pr ocess was investigated. RESULTS: One hundred forty-one (92.15%) of 153 eyes achieved at least 3-mon th follow-up. At least one complication occurred in 53 of 153 eyes (34.6%) and in 51 of these 53 eyes (96.22%) the complications occurred before 3 mon ths of postoperative follow-up. The intraoperative and postoperative compli cations included retinal detachment (17.4%), retinal breaks (13.4%), macula r holes (7.8%), macular fold (4.6%), and intraocular hemorrhage (vitreous, subretinal, or choroidal; 9.2%). Eyes that developed retinal detachment, su bretinal hemorrhage, and macular fold had significantly more loss of visual acuity than eyes without each of these omplications (P = .0001, P = .038, and P = .027, respectively). The presence of predominantly classic choroida l neovascularization, the occurrence of an intra operative retinal break, a ny intraocular hemorrhage, or macular fold formation were significantly ass ociated with retinal detachment (P = .021, P = .025, P = .013, and P = .014 , respectively). The incidence of any complication, retinal detachment, and hemorrhage significantly decreased during the study period, suggesting a l earning process (P = .03, P = .006, P = .027, respectively). CONCLUSIONS: A variety of ocular complications can occur during or after li mited macular translocation, and some are associated with reduced postopera tive visual acuity, Improved surgical techniques and experience may signifi cantly reduce the incidence of these complications. (C) 2000 by Elsevier Sc ience Inc. All rights reserved.