Macular translocation with 360-degree peripheral retinectomy - Impact of technique and surgical experience on visual outcomes

Purpose: To evaluate the impact of technique and surgical experience on com plications and outcomes of macular translocation surgery with 360-degree pe ripheral retinectomy (MTS360). Methods: Twenty-six consecutive patients underwent MTS360 in a prospective study of macular translocation surgery for subfoveal choroidal neovasculari zation (CNV) in eyes with age-related macular degeneration (ARMD). Data gat hered included intraoperative and postoperative events and pre- and postope rative standardized visual acuity recorded as number of letters read. Becau se the surgical technique changed particularly during the first 16 cases, p atients were grouped into an evolving treatment group of the first 16 patie nts (Group 1) and a modified treatment group of the final 10 patients (Grou p 2). Results: As techniques evolved in this series, ease of surgery increased. T here were significant decreases in surgery duration and in number of retino tomies required to induce artificial retinal detachment. Number of postoper ative retinal detachments decreased from five in Group 1 to none in Group 2 . Change in visual acuity was significantly different between the two group s: Group 1 had an average loss of 14 letters (<3 lines) and Group 2 an aver age gain of 3 letters (<1 line) (P < 0.05). Average postoperative visual ac uity was significantly better for Group 2 (68 letters, approximately 20/80) than for Group 1 (47 letters, approximately 20/250) (P < 0.01). Conclusion: Surgical experience and a progressively modified surgical techn ique decreased perioperative complications and improved visual outcomes aft er MTS360. With modified MTS360, central vision has been salvaged for almos t 1 year of follow-up in patients presenting with vision loss from subfovea l CNV and ARMD.