Foveal translocation with scleral imbrication in patients with myopic neovascular maculopathy.
OBJECTIVE
To report our surgical results of foveal translocation with scleral imbrication in patients with myopic neovascular maculopathy.


METHODS
Noncomparative, interventional, consecutive case series.


METHODS
Ten eyes of 10 myopic patients with subfoveal neovascular membranes that had undergone foveal translocation with scleral imbrication were recruited for this retrospective study. Inclusion criteria were myopia 6.0 diopters or greater in refractive error (or axial length 26.5 mm or longer), subfoveal choroidal neovascularization, and preoperative best-corrected visual acuity of 20/100 or worse. None of these eyes had undergone prior laser photocoagulation or submacular surgery. The main outcome measures were surgical complications and postoperative visual function.


RESULTS
Postoperatively, visual acuity had improved more than 3 lines in the logarithm of minimum angle of resolution (logMAR) measurement in all eyes. The mean preoperative, postoperative best, and final visual acuity were 0.12, 0.59, and 0.51, respectively. Of the 10 eyes, six achieved a postoperative final visual acuity of 20/40 or better. The mean postoperative foveal displacement was 0.78 disk diameter (range, 0.3--1.3 disk diameter). Two patients underwent a reoperation because of insufficient foveal displacement. Furthermore, one of these two patients required a third operation to reduce an excessive retinal fold involving the fovea induced by the second surgery. Of the 10 patients, two noted transient diplopia. This complaint, however, resolved over time as suppression developed. Although unintentional iatrogenic retinal tears formed intraoperatively in two eyes, these were successfully treated without serious complications. Postoperatively, mild retinal pigment epithelial changes were observed in all cases, but none led to significant deterioration of visual acuity during the follow-up period. All patients but one were followed for a minimum of 6 months.


CONCLUSIONS
In eyes with myopic neovascular maculopathy, foveal translocation with scleral imbrication may be useful in improving visual acuity. Further refinements in surgical technique and assessment of the long-term complications will be needed to make this procedure safer and more useful.
Ichibe
M
M
Department of Ophthalmology, Niigata University School of Medicine, Asahimachi, Niigata, Japan. tyoshi@med.niigata-u.ac.jp
Imai
K
K
Ohta
M
M
Hasebe
H
H
Yoshizawa
T
T
Abe
H
H
D000328:Adult; D000368:Aged; D020256:Choroidal Neovascularization / Q000209:etiology / Q000601:surgery*; D005260:Female; D005451:Fluorescein Angiography; D005584:Fovea Centralis / Q000637:transplantation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000150:complications*; D013508:Ophthalmologic Surgical Procedures; D011183:Postoperative Complications; D012086:Reoperation; D012189:Retrospective Studies; D012590:Sclera / Q000601:surgery*; D016896:Treatment Outcome; D014792:Visual Acuity