Comparison of three techniques of foveal translocation in patients with subfoveal choroidal neovascularization resulting from age-related macular degeneration.
OBJECTIVE
To report the results of three methods of foveal translocation in the presence of subfoveal choroidal neovascular membrane resulting from age-related macular degeneration.


METHODS
We treated 51 eyes of 51 consecutive patients with subfoveal choroidal neovascular membranes resulting from age-related macular degeneration with one of three techniques of foveal translocation surgery: foveal translocation with partial retinotomy (n = 6), limited translocation (n = 9), and translocation with 360-degree retinotomy (n = 36). All patients were followed for at least 6 months postoperatively. The size of the choroidal neovascular membrane and the amount of foveal displacement, the best-corrected visual acuity, and complications were recorded preoperatively and postoperatively.


RESULTS
The mean distance of the foveal translocation was greater in the 360-degree retinotomy group (3340 microm) than in the partial retinotomy (1060 microm, P <.001) and the limited translocation groups (1120 microm, P <.001). A final visual acuity of 20/200 or better was achieved in two eyes (33%) in the partial retinotomy group, seven eyes (78%) in the limited translocation group, and 23 eyes (64%) in the 360-degree retinotomy group. The final visual acuity improved by 0.2 logarithm of minimal angle of resolution (logMAR) unit or more in one eye (17%), one eye (11%), and seven eyes (19%), respectively. The final visual acuity was maintained within 1 line in zero eyes, five eyes (56%), and 19 eyes (53%), respectively. A retinal detachment developed postoperatively in five eyes (83%), zero eyes (0%), and 15 eyes (42%), respectively.


CONCLUSIONS
A significant number of patients improved or maintained best-corrected visual acuity after translocation with 360-degree retinotomy, and limited translocation, whereas translocation with 360-degree retinotomy is suitable for larger choroidal neovascular membranes because it resulted in the greatest foveal displacement among the three translocation procedures.
Ohji
M
M
Department of Ophthalmology, Osaka University Medical School, 2-2 Yamadaoka, Suita, 565-0871, Japan. ohji@ophthal.med.osaka-u.ac.jp
Fujikado
T
T
Kusaka
S
S
Hayashi
A
A
Hosohata
J
J
Ikuno
Y
Y
Sawa
M
M
Kubota
A
A
Hashida
N
N
Tano
Y
Y
D000368:Aged; D000369:Aged, 80 and over; D020256:Choroidal Neovascularization / Q000209:etiology / Q000601:surgery*; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D005584:Fovea Centralis / Q000637:transplantation*; D006801:Humans; D008268:Macular Degeneration / Q000150:complications*; D008297:Male; D008875:Middle Aged; D019737:Transplants; D016896:Treatment Outcome; D014792:Visual Acuity